Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ARISTA HEMOSTAT 3 GRAM

Facility

$812.50

Hospital Charge Code	270687374
Hospital Revenue Code	272
Min. Negotiated Rate	$121.88
Max. Negotiated Rate	$121.88
Rate for Payer: Qualcare PPO/HMO/WC	$121.88

ARMADA 35 PTA 7.0mmx80mmx80cm

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270680400
Hospital Revenue Code	278
Min. Negotiated Rate	$93.75
Max. Negotiated Rate	$151.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75

ARMADA 35 PTA 7.0mmx80mmx80cm

Facility

$625.00

Service Code	HCPCS C1725
Hospital Charge Code	270680400
Hospital Revenue Code	278
Min. Negotiated Rate	$17.75
Max. Negotiated Rate	$312.50
Rate for Payer: Aetna Commercial	$237.50
Rate for Payer: Aetna Medicare Advantage	$187.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$159.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$125.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$159.38
Rate for Payer: Cigna Commercial	$312.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$151.25
Rate for Payer: Qualcare PPO/HMO/WC	$93.75
Rate for Payer: UnitedHealthcare Community & State	$19.75
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

ARM AIMING RADIOLUCENT

Facility

$9,504.00

Hospital Charge Code	270671055
Hospital Revenue Code	272
Min. Negotiated Rate	$269.91
Max. Negotiated Rate	$4,752.00
Rate for Payer: Aetna Commercial	$3,611.52
Rate for Payer: Aetna Medicare Advantage	$2,851.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,423.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,423.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,423.52
Rate for Payer: Cigna Commercial	$4,752.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,471.04
Rate for Payer: Oxford Commercial	$1,900.80
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.60
Rate for Payer: UnitedHealthcare Commercial	$1,900.80
Rate for Payer: UnitedHealthcare Community & State	$300.33
Rate for Payer: Wellpoint Medicaid Managed Care	$269.91

ARM AIMING RADIOLUCENT

Facility

$9,504.00

Hospital Charge Code	270671055
Hospital Revenue Code	272
Min. Negotiated Rate	$1,425.60
Max. Negotiated Rate	$1,425.60
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.60

ARM BOARD, DISPOSABLE 3.25X18

Facility

$14.00

Hospital Charge Code	270332274
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

ARM BOARD, DISPOSABLE 3.25X18

Facility

$14.00

Hospital Charge Code	270332274
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$7.00
Rate for Payer: Aetna Commercial	$5.32
Rate for Payer: Aetna Medicare Advantage	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.57
Rate for Payer: Cigna Commercial	$7.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.64
Rate for Payer: Oxford Commercial	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$2.80
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

ARMBOARD INFANT 9

Facility

$2.33

Hospital Charge Code	270300070
Hospital Revenue Code	270
Min. Negotiated Rate	$0.07
Max. Negotiated Rate	$1.17
Rate for Payer: Aetna Commercial	$0.89
Rate for Payer: Aetna Medicare Advantage	$0.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.59
Rate for Payer: Cigna Commercial	$1.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.61
Rate for Payer: Oxford Commercial	$0.47
Rate for Payer: Qualcare PPO/HMO/WC	$0.35
Rate for Payer: UnitedHealthcare Commercial	$0.47
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.07

ARMBOARD INFANT 9

Facility

$2.33

Hospital Charge Code	270300070
Hospital Revenue Code	270
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$0.35
Rate for Payer: Qualcare PPO/HMO/WC	$0.35

ARM BOARD PADS

Facility

$531.75

Hospital Charge Code	270691391
Hospital Revenue Code	270
Min. Negotiated Rate	$79.76
Max. Negotiated Rate	$79.76
Rate for Payer: Qualcare PPO/HMO/WC	$79.76

ARM BOARD PADS

Facility

$531.75

Hospital Charge Code	270691391
Hospital Revenue Code	270
Min. Negotiated Rate	$15.10
Max. Negotiated Rate	$265.88
Rate for Payer: Aetna Commercial	$202.06
Rate for Payer: Aetna Medicare Advantage	$159.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$135.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$135.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$135.60
Rate for Payer: Cigna Commercial	$265.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$138.25
Rate for Payer: Oxford Commercial	$106.35
Rate for Payer: Qualcare PPO/HMO/WC	$79.76
Rate for Payer: UnitedHealthcare Commercial	$106.35
Rate for Payer: UnitedHealthcare Community & State	$16.80
Rate for Payer: Wellpoint Medicaid Managed Care	$15.10

ARM MOUNTAIN LONG

Facility

$3,463.85

Hospital Charge Code	270679746
Hospital Revenue Code	272
Min. Negotiated Rate	$519.58
Max. Negotiated Rate	$519.58
Rate for Payer: Qualcare PPO/HMO/WC	$519.58

ARM MOUNTAIN LONG

Facility

$3,463.85

Hospital Charge Code	270679746
Hospital Revenue Code	272
Min. Negotiated Rate	$98.37
Max. Negotiated Rate	$1,731.92
Rate for Payer: Aetna Commercial	$1,316.26
Rate for Payer: Aetna Medicare Advantage	$1,039.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$883.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$883.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$883.28
Rate for Payer: Cigna Commercial	$1,731.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$900.60
Rate for Payer: Oxford Commercial	$692.77
Rate for Payer: Qualcare PPO/HMO/WC	$519.58
Rate for Payer: UnitedHealthcare Commercial	$692.77
Rate for Payer: UnitedHealthcare Community & State	$109.46
Rate for Payer: Wellpoint Medicaid Managed Care	$98.37

ARMOUR THYROID 30MG TAB

Facility

$4.00

Service Code	NDC 456045801
Hospital Charge Code	6063943058
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

ARMOUR THYROID 30MG TAB

Facility

$4.00

Service Code	NDC 456045801
Hospital Charge Code	6063943058
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ARMOUR THYROID 60MG TABLET

Facility

$4.00

Service Code	NDC 456045901
Hospital Charge Code	60632374
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

ARMOUR THYROID 60MG TABLET

Facility

$4.00

Service Code	NDC 456045901
Hospital Charge Code	60632374
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

ARM SLING CHIEFTAIN LARGE

Facility

$10.90

Hospital Charge Code	270649889
Hospital Revenue Code	270
Min. Negotiated Rate	$0.31
Max. Negotiated Rate	$5.45
Rate for Payer: Aetna Commercial	$4.14
Rate for Payer: Aetna Medicare Advantage	$3.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.78
Rate for Payer: Cigna Commercial	$5.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.83
Rate for Payer: Oxford Commercial	$2.18
Rate for Payer: Qualcare PPO/HMO/WC	$1.64
Rate for Payer: UnitedHealthcare Commercial	$2.18
Rate for Payer: UnitedHealthcare Community & State	$0.34
Rate for Payer: Wellpoint Medicaid Managed Care	$0.31

ARM SLING CHIEFTAIN LARGE

Facility

$10.90

Hospital Charge Code	270649889
Hospital Revenue Code	270
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.64

ARM SLING CHIEFTAIN MEDIUM

Facility

$10.10

Hospital Charge Code	270649888
Hospital Revenue Code	270
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.51

ARM SLING CHIEFTAIN MEDIUM

Facility

$10.10

Hospital Charge Code	270649888
Hospital Revenue Code	270
Min. Negotiated Rate	$0.29
Max. Negotiated Rate	$5.05
Rate for Payer: Aetna Commercial	$3.84
Rate for Payer: Aetna Medicare Advantage	$3.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.58
Rate for Payer: Cigna Commercial	$5.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.63
Rate for Payer: Oxford Commercial	$2.02
Rate for Payer: Qualcare PPO/HMO/WC	$1.51
Rate for Payer: UnitedHealthcare Commercial	$2.02
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.29

ARM SLING CHIEFTAIN SMALL

Facility

$11.50

Hospital Charge Code	270649891
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$5.75
Rate for Payer: Aetna Commercial	$4.37
Rate for Payer: Aetna Medicare Advantage	$3.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.93
Rate for Payer: Cigna Commercial	$5.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.99
Rate for Payer: Oxford Commercial	$2.30
Rate for Payer: Qualcare PPO/HMO/WC	$1.73
Rate for Payer: UnitedHealthcare Commercial	$2.30
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

ARM SLING CHIEFTAIN SMALL

Facility

$11.50

Hospital Charge Code	270649891
Hospital Revenue Code	270
Min. Negotiated Rate	$1.73
Max. Negotiated Rate	$1.73
Rate for Payer: Qualcare PPO/HMO/WC	$1.73

ARM SLING LRG

Facility

$7.35

Hospital Charge Code	270649357S
Hospital Revenue Code	271
Min. Negotiated Rate	$1.10
Max. Negotiated Rate	$1.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.10

ARM SLING LRG

Facility

$7.35

Hospital Charge Code	270649357S
Hospital Revenue Code	271
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.67
Rate for Payer: Aetna Commercial	$2.79
Rate for Payer: Aetna Medicare Advantage	$2.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.87
Rate for Payer: Cigna Commercial	$3.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.91
Rate for Payer: Oxford Commercial	$1.47
Rate for Payer: Qualcare PPO/HMO/WC	$1.10
Rate for Payer: UnitedHealthcare Commercial	$1.47
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

Know your out-of-pocket cost for care.

All Charges