Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

MEDIHONEY GEL TUBE

Facility

$66.06

Service Code	NDC 9958003461
Hospital Charge Code	606390420
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$33.03
Rate for Payer: Aetna Commercial	$25.10
Rate for Payer: Aetna Medicare Advantage	$19.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.85
Rate for Payer: Cigna Commercial	$33.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.18
Rate for Payer: Oxford Commercial	$13.21
Rate for Payer: Qualcare PPO/HMO/WC	$9.91
Rate for Payer: UnitedHealthcare Commercial	$13.21
Rate for Payer: UnitedHealthcare Community & State	$2.09
Rate for Payer: Wellpoint Medicaid Managed Care	$1.88

MEDIHONEY GEL TUBE

Facility

$95.12

Hospital Charge Code	606351017
Hospital Revenue Code	250
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$47.56
Rate for Payer: Aetna Commercial	$36.15
Rate for Payer: Aetna Medicare Advantage	$28.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.26
Rate for Payer: Cigna Commercial	$47.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.73
Rate for Payer: Oxford Commercial	$19.02
Rate for Payer: Qualcare PPO/HMO/WC	$14.27
Rate for Payer: UnitedHealthcare Commercial	$19.02
Rate for Payer: UnitedHealthcare Community & State	$3.01
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

MEDIHONEY GEL TUBE

Facility

$95.12

Hospital Charge Code	606351017
Hospital Revenue Code	250
Min. Negotiated Rate	$14.27
Max. Negotiated Rate	$14.27
Rate for Payer: Qualcare PPO/HMO/WC	$14.27

MEDIHONEY GEL TUBE

Facility

$82.19

Hospital Charge Code	606380009
Hospital Revenue Code	250
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$41.09
Rate for Payer: Aetna Commercial	$31.23
Rate for Payer: Aetna Medicare Advantage	$24.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.96
Rate for Payer: Cigna Commercial	$41.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.37
Rate for Payer: Oxford Commercial	$16.44
Rate for Payer: Qualcare PPO/HMO/WC	$12.33
Rate for Payer: UnitedHealthcare Commercial	$16.44
Rate for Payer: UnitedHealthcare Community & State	$2.60
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

MEDIHONEY GEL TUBE

Facility

$82.19

Hospital Charge Code	606380009
Hospital Revenue Code	250
Min. Negotiated Rate	$12.33
Max. Negotiated Rate	$12.33
Rate for Payer: Qualcare PPO/HMO/WC	$12.33

MED MALLWOLUS PT 7- HOL ANATM

Facility

$7,136.25

Service Code	HCPCS C1713
Hospital Charge Code	270701647
Hospital Revenue Code	278
Min. Negotiated Rate	$1,070.44
Max. Negotiated Rate	$1,726.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,427.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,726.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,070.44

MED MALLWOLUS PT 7- HOL ANATM

Facility

$7,136.25

Service Code	HCPCS C1713
Hospital Charge Code	270701647
Hospital Revenue Code	278
Min. Negotiated Rate	$202.67
Max. Negotiated Rate	$3,568.12
Rate for Payer: Aetna Commercial	$2,711.78
Rate for Payer: Aetna Medicare Advantage	$2,140.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,819.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,819.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,427.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,819.74
Rate for Payer: Cigna Commercial	$3,568.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,726.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,070.44
Rate for Payer: UnitedHealthcare Community & State	$225.51
Rate for Payer: Wellpoint Medicaid Managed Care	$202.67

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4511608
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4511608
Hospital Revenue Code	919
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4832608
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4504608
Hospital Revenue Code	919
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4535608
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4832608
Hospital Revenue Code	919
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4818608
Hospital Revenue Code	919
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4502608
Hospital Revenue Code	919
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4822608
Hospital Revenue Code	919
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4822608
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4818608
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4504608
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4502608
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG ADULT/15MIN MEDICAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4535608
Hospital Revenue Code	919
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

MED MNG ADULT/15MIN PH MCAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4509622
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG ADULT/15MIN PH MCAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4822622
Hospital Revenue Code	919
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

MED MNG ADULT/15MIN PH MCAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4509622
Hospital Revenue Code	919
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

MED MNG ADULT/15MIN PH MCAID

Facility

$375.00

Service Code	HCPCS 99211
Hospital Charge Code	4822622
Hospital Revenue Code	919
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

Know your out-of-pocket cost for care.

All Charges