Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NALTREXONE 50 MG TAB

Facility

$28.61

Service Code	NDC 16729008101
Hospital Charge Code	60628852
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$14.30
Rate for Payer: Aetna Commercial	$10.87
Rate for Payer: Aetna Medicare Advantage	$8.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.30
Rate for Payer: Cigna Commercial	$14.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.44
Rate for Payer: Oxford Commercial	$5.72
Rate for Payer: Qualcare PPO/HMO/WC	$4.29
Rate for Payer: UnitedHealthcare Commercial	$5.72
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

NanoCross .014 Long 150mm -210

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270686204
Hospital Revenue Code	278
Min. Negotiated Rate	$277.83
Max. Negotiated Rate	$448.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83

NanoCross .014 Long 150mm -210

Facility

$1,852.20

Service Code	HCPCS C1725
Hospital Charge Code	270686204
Hospital Revenue Code	278
Min. Negotiated Rate	$52.60
Max. Negotiated Rate	$926.10
Rate for Payer: Aetna Commercial	$703.84
Rate for Payer: Aetna Medicare Advantage	$555.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$472.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$370.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$472.31
Rate for Payer: Cigna Commercial	$926.10
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$448.23
Rate for Payer: Qualcare PPO/HMO/WC	$277.83
Rate for Payer: UnitedHealthcare Community & State	$58.53
Rate for Payer: Wellpoint Medicaid Managed Care	$52.60

NANONEEDLE SCOPE 180MM

Facility

$1,750.00

Hospital Charge Code	270704957
Hospital Revenue Code	279
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$262.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

NANONEEDLE SCOPE 180MM

Facility

$1,750.00

Hospital Charge Code	270704957
Hospital Revenue Code	279
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$455.00
Rate for Payer: Oxford Commercial	$350.00
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Commercial	$350.00
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

NANONEEDLE SCOPE HFLO KIT 180

Facility

$425.00

Hospital Charge Code	270704958
Hospital Revenue Code	279
Min. Negotiated Rate	$12.07
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$85.00
Rate for Payer: UnitedHealthcare Community & State	$13.43
Rate for Payer: Wellpoint Medicaid Managed Care	$12.07

NANONEEDLE SCOPE HFLO KIT 180

Facility

$425.00

Hospital Charge Code	270704958
Hospital Revenue Code	279
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

NANO STEMLESS SHOULDER 38MM

Facility

$44,378.25

Service Code	HCPCS C1716
Hospital Charge Code	270705539
Hospital Revenue Code	278
Min. Negotiated Rate	$6,656.74
Max. Negotiated Rate	$10,739.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,875.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,739.54
Rate for Payer: Qualcare PPO/HMO/WC	$6,656.74

NANO STEMLESS SHOULDER 38MM

Facility

$44,378.25

Service Code	HCPCS C1716
Hospital Charge Code	270705539
Hospital Revenue Code	278
Min. Negotiated Rate	$567.34
Max. Negotiated Rate	$10,739.54
Rate for Payer: Aetna Commercial	$1,624.38
Rate for Payer: Aetna Medicare Advantage	$1,934.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,166.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,166.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,875.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,166.34
Rate for Payer: Cigna Commercial	$1,197.08
Rate for Payer: Cigna Medicare Advantage	$597.20
Rate for Payer: Clover Medicare Advantage	$567.34
Rate for Payer: EmblemHealth Commercial	$1,791.60
Rate for Payer: Humana Medicare Advantage	$615.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$597.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,739.54
Rate for Payer: Qualcare PPO/HMO/WC	$6,656.74
Rate for Payer: UnitedHealthcare Community & State	$1,402.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$597.20
Rate for Payer: Wellcare Medicare Advantage	$597.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1,260.34

NAPHAZOLINE-PHENIRAMINE OPH S

Facility

$127.37

Service Code	NDC 52959010703
Hospital Charge Code	60628837
Hospital Revenue Code	250
Min. Negotiated Rate	$19.11
Max. Negotiated Rate	$19.11
Rate for Payer: Qualcare PPO/HMO/WC	$19.11

NAPHAZOLINE-PHENIRAMINE OPH S

Facility

$127.37

Service Code	NDC 52959010703
Hospital Charge Code	60628837
Hospital Revenue Code	250
Min. Negotiated Rate	$3.62
Max. Negotiated Rate	$63.69
Rate for Payer: Aetna Commercial	$48.40
Rate for Payer: Aetna Medicare Advantage	$38.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.48
Rate for Payer: Cigna Commercial	$63.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.12
Rate for Payer: Oxford Commercial	$25.47
Rate for Payer: Qualcare PPO/HMO/WC	$19.11
Rate for Payer: UnitedHealthcare Commercial	$25.47
Rate for Payer: UnitedHealthcare Community & State	$4.02
Rate for Payer: Wellpoint Medicaid Managed Care	$3.62

NA POLYSTYRENE SULF PWDR 15GM

Facility

$90.52

Service Code	NDC 10702003615
Hospital Charge Code	606390210
Hospital Revenue Code	250
Min. Negotiated Rate	$2.57
Max. Negotiated Rate	$45.26
Rate for Payer: Aetna Commercial	$34.40
Rate for Payer: Aetna Medicare Advantage	$27.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.08
Rate for Payer: Cigna Commercial	$45.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.54
Rate for Payer: Oxford Commercial	$18.10
Rate for Payer: Qualcare PPO/HMO/WC	$13.58
Rate for Payer: UnitedHealthcare Commercial	$18.10
Rate for Payer: UnitedHealthcare Community & State	$2.86
Rate for Payer: Wellpoint Medicaid Managed Care	$2.57

NA POLYSTYRENE SULF PWDR 15GM

Facility

$90.52

Service Code	NDC 10702003615
Hospital Charge Code	606390210
Hospital Revenue Code	250
Min. Negotiated Rate	$13.58
Max. Negotiated Rate	$13.58
Rate for Payer: Qualcare PPO/HMO/WC	$13.58

NAPROXEN 250 MG TAB

Facility

$5.23

Service Code	NDC 31722034001
Hospital Charge Code	60627691
Hospital Revenue Code	250
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$0.78
Rate for Payer: Qualcare PPO/HMO/WC	$0.78

NAPROXEN 250 MG TAB

Facility

$5.23

Service Code	NDC 31722034001
Hospital Charge Code	60627691
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$2.62
Rate for Payer: Aetna Commercial	$1.99
Rate for Payer: Aetna Medicare Advantage	$1.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.33
Rate for Payer: Cigna Commercial	$2.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.36
Rate for Payer: Oxford Commercial	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$0.78
Rate for Payer: UnitedHealthcare Commercial	$1.05
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

NAPROXEN 375 MG TAB

Facility

$7.10

Service Code	NDC 31722034101
Hospital Charge Code	60627693
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$1.06
Rate for Payer: Qualcare PPO/HMO/WC	$1.06

NAPROXEN 375 MG TAB

Facility

$7.10

Service Code	NDC 31722034101
Hospital Charge Code	60627693
Hospital Revenue Code	250
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.55
Rate for Payer: Aetna Commercial	$2.70
Rate for Payer: Aetna Medicare Advantage	$2.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.81
Rate for Payer: Cigna Commercial	$3.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.85
Rate for Payer: Oxford Commercial	$1.42
Rate for Payer: Qualcare PPO/HMO/WC	$1.06
Rate for Payer: UnitedHealthcare Commercial	$1.42
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

NAPROXEN 500MG TAB

Facility

$8.98

Service Code	NDC 68084012701
Hospital Charge Code	6063943144
Hospital Revenue Code	250
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$1.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.35

NAPROXEN 500MG TAB

Facility

$8.98

Service Code	NDC 68084012701
Hospital Charge Code	6063943144
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$4.49
Rate for Payer: Aetna Commercial	$3.41
Rate for Payer: Aetna Medicare Advantage	$2.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.29
Rate for Payer: Cigna Commercial	$4.49
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.33
Rate for Payer: Oxford Commercial	$1.80
Rate for Payer: Qualcare PPO/HMO/WC	$1.35
Rate for Payer: UnitedHealthcare Commercial	$1.80
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

NAPSIN-A-IHC

Facility

$2,164.00

Service Code	HCPCS 88342
Hospital Charge Code	4016883425
Hospital Revenue Code	310
Min. Negotiated Rate	$324.60
Max. Negotiated Rate	$324.60
Rate for Payer: Qualcare PPO/HMO/WC	$324.60

NAPSIN-A-IHC

Facility

$2,164.00

Service Code	HCPCS 88342
Hospital Charge Code	4016883425
Hospital Revenue Code	310
Min. Negotiated Rate	$61.46
Max. Negotiated Rate	$734.21
Rate for Payer: Aetna Commercial	$550.53
Rate for Payer: Aetna Medicare Advantage	$655.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$734.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$202.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$734.21
Rate for Payer: Cigna Commercial	$405.73
Rate for Payer: Cigna Medicare Advantage	$202.40
Rate for Payer: Clover Medicare Advantage	$192.28
Rate for Payer: EmblemHealth Commercial	$607.20
Rate for Payer: Humana Medicare Advantage	$208.47
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$202.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$562.64
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$324.60
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$86.39
Rate for Payer: UnitedHealthcare Medicare Advantage	$202.40
Rate for Payer: Wellcare Medicare Advantage	$202.40
Rate for Payer: Wellpoint Medicaid Managed Care	$61.46

NARROW HOOK 10 MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687612
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

NARROW HOOK 10 MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687612
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

NARROW HOOK 8 MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687613
Hospital Revenue Code	278
Min. Negotiated Rate	$113.60
Max. Negotiated Rate	$2,000.00
Rate for Payer: Aetna Commercial	$1,520.00
Rate for Payer: Aetna Medicare Advantage	$1,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,020.00
Rate for Payer: Cigna Commercial	$2,000.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00
Rate for Payer: UnitedHealthcare Community & State	$126.40
Rate for Payer: Wellpoint Medicaid Managed Care	$113.60

NARROW HOOK 8 MM

Facility

$4,000.00

Service Code	HCPCS C1713
Hospital Charge Code	270687613
Hospital Revenue Code	278
Min. Negotiated Rate	$600.00
Max. Negotiated Rate	$968.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$968.00
Rate for Payer: Qualcare PPO/HMO/WC	$600.00

Know your out-of-pocket cost for care.

All Charges