Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NEG PRESS WOUND TX<=50CN

Facility

$826.36

Service Code	HCPCS 97605
Hospital Charge Code	1600000699
Hospital Revenue Code	360
Min. Negotiated Rate	$123.95
Max. Negotiated Rate	$123.95
Rate for Payer: Qualcare PPO/HMO/WC	$123.95

NEISSERIA GONORRHOEAE

Facility

$390.00

Service Code	HCPCS 87591
Hospital Charge Code	39708053C
Hospital Revenue Code	306
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

NEISSERIA GONORRHOEAE

Facility

$390.00

Service Code	HCPCS 87591
Hospital Charge Code	39708053C
Hospital Revenue Code	306
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$95.44
Rate for Payer: Aetna Medicare Advantage	$113.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$127.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$35.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$127.29
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$35.09
Rate for Payer: Clover Medicare Advantage	$33.34
Rate for Payer: EmblemHealth Commercial	$105.27
Rate for Payer: Humana Medicare Advantage	$36.14
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$35.09
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	$28.07
Rate for Payer: UnitedHealthcare Medicare Advantage	$35.09
Rate for Payer: Wellcare Medicare Advantage	$35.09
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

NELFINAVIR 250 MG TAB

Facility

$26.13

Service Code	NDC 63010001030
Hospital Charge Code	60628664
Hospital Revenue Code	250
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$13.06
Rate for Payer: Aetna Commercial	$9.93
Rate for Payer: Aetna Medicare Advantage	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.66
Rate for Payer: Cigna Commercial	$13.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.79
Rate for Payer: Oxford Commercial	$5.23
Rate for Payer: Qualcare PPO/HMO/WC	$3.92
Rate for Payer: UnitedHealthcare Commercial	$5.23
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

NELFINAVIR 250 MG TAB

Facility

$26.13

Service Code	NDC 63010001030
Hospital Charge Code	60628664
Hospital Revenue Code	250
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$3.92
Rate for Payer: Qualcare PPO/HMO/WC	$3.92

NEOGUARD TRANSDUCER COVER

Facility

$29.17

Hospital Charge Code	270667952
Hospital Revenue Code	270
Min. Negotiated Rate	$4.38
Max. Negotiated Rate	$4.38
Rate for Payer: Qualcare PPO/HMO/WC	$4.38

NEOGUARD TRANSDUCER COVER

Facility

$29.17

Hospital Charge Code	270667952
Hospital Revenue Code	270
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$14.59
Rate for Payer: Aetna Commercial	$11.08
Rate for Payer: Aetna Medicare Advantage	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.44
Rate for Payer: Cigna Commercial	$14.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.58
Rate for Payer: Oxford Commercial	$5.83
Rate for Payer: Qualcare PPO/HMO/WC	$4.38
Rate for Payer: UnitedHealthcare Commercial	$5.83
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$0.83

NEOMYCIN 500 MG TAB

Facility

$9.98

Service Code	NDC 93117701
Hospital Charge Code	60627242
Hospital Revenue Code	251
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

NEOMYCIN 500 MG TAB

Facility

$9.98

Service Code	NDC 93117701
Hospital Charge Code	60627242
Hospital Revenue Code	251
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.99
Rate for Payer: Aetna Commercial	$3.79
Rate for Payer: Aetna Medicare Advantage	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.54
Rate for Payer: Cigna Commercial	$4.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.59
Rate for Payer: Oxford Commercial	$2.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.50
Rate for Payer: UnitedHealthcare Commercial	$2.00
Rate for Payer: UnitedHealthcare Community & State	$0.32
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

NEOMYCIN POLY BACIT OINT

Facility

$54.67

Service Code	NDC 472017956
Hospital Charge Code	60628328
Hospital Revenue Code	250
Min. Negotiated Rate	$8.20
Max. Negotiated Rate	$8.20
Rate for Payer: Qualcare PPO/HMO/WC	$8.20

NEOMYCIN POLY BACIT OINT

Facility

$54.67

Service Code	NDC 472017956
Hospital Charge Code	60628328
Hospital Revenue Code	250
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$27.34
Rate for Payer: Aetna Commercial	$20.77
Rate for Payer: Aetna Medicare Advantage	$16.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.94
Rate for Payer: Cigna Commercial	$27.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.21
Rate for Payer: Oxford Commercial	$10.93
Rate for Payer: Qualcare PPO/HMO/WC	$8.20
Rate for Payer: UnitedHealthcare Commercial	$10.93
Rate for Payer: UnitedHealthcare Community & State	$1.73
Rate for Payer: Wellpoint Medicaid Managed Care	$1.55

NEOMYCIN POLY BACIT OPH IONT

Facility

$370.18

Service Code	NDC 17478023535
Hospital Charge Code	60628016
Hospital Revenue Code	250
Min. Negotiated Rate	$55.53
Max. Negotiated Rate	$55.53
Rate for Payer: Qualcare PPO/HMO/WC	$55.53

NEOMYCIN POLY BACIT OPH IONT

Facility

$370.18

Service Code	NDC 17478023535
Hospital Charge Code	60628016
Hospital Revenue Code	250
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$185.09
Rate for Payer: Aetna Commercial	$140.67
Rate for Payer: Aetna Medicare Advantage	$111.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.40
Rate for Payer: Cigna Commercial	$185.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.25
Rate for Payer: Oxford Commercial	$74.04
Rate for Payer: Qualcare PPO/HMO/WC	$55.53
Rate for Payer: UnitedHealthcare Commercial	$74.04
Rate for Payer: UnitedHealthcare Community & State	$11.70
Rate for Payer: Wellpoint Medicaid Managed Care	$10.51

NEOMYCIN POLY DEXAMTH OPH OINT

Facility

$133.06

Service Code	NDC 24208079535
Hospital Charge Code	60628017
Hospital Revenue Code	250
Min. Negotiated Rate	$19.96
Max. Negotiated Rate	$19.96
Rate for Payer: Qualcare PPO/HMO/WC	$19.96

NEOMYCIN POLY DEXAMTH OPH OINT

Facility

$133.06

Service Code	NDC 24208079535
Hospital Charge Code	60628017
Hospital Revenue Code	250
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$66.53
Rate for Payer: Aetna Commercial	$50.56
Rate for Payer: Aetna Medicare Advantage	$39.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.93
Rate for Payer: Cigna Commercial	$66.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.60
Rate for Payer: Oxford Commercial	$26.61
Rate for Payer: Qualcare PPO/HMO/WC	$19.96
Rate for Payer: UnitedHealthcare Commercial	$26.61
Rate for Payer: UnitedHealthcare Community & State	$4.20
Rate for Payer: Wellpoint Medicaid Managed Care	$3.78

NEOMYCIN POLY DEXAMTH OPH SSP

Facility

$133.06

Service Code	NDC 24208083060
Hospital Charge Code	60628018
Hospital Revenue Code	250
Min. Negotiated Rate	$19.96
Max. Negotiated Rate	$19.96
Rate for Payer: Qualcare PPO/HMO/WC	$19.96

NEOMYCIN POLY DEXAMTH OPH SSP

Facility

$133.06

Service Code	NDC 24208083060
Hospital Charge Code	60628018
Hospital Revenue Code	250
Min. Negotiated Rate	$3.78
Max. Negotiated Rate	$66.53
Rate for Payer: Aetna Commercial	$50.56
Rate for Payer: Aetna Medicare Advantage	$39.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$33.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$33.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$33.93
Rate for Payer: Cigna Commercial	$66.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.60
Rate for Payer: Oxford Commercial	$26.61
Rate for Payer: Qualcare PPO/HMO/WC	$19.96
Rate for Payer: UnitedHealthcare Commercial	$26.61
Rate for Payer: UnitedHealthcare Community & State	$4.20
Rate for Payer: Wellpoint Medicaid Managed Care	$3.78

NEOMYCIN POLY GRAM OPH SOL

Facility

$415.00

Service Code	NDC 24208079062
Hospital Charge Code	60628019
Hospital Revenue Code	250
Min. Negotiated Rate	$62.25
Max. Negotiated Rate	$62.25
Rate for Payer: Qualcare PPO/HMO/WC	$62.25

NEOMYCIN POLY GRAM OPH SOL

Facility

$415.00

Service Code	NDC 24208079062
Hospital Charge Code	60628019
Hospital Revenue Code	250
Min. Negotiated Rate	$11.79
Max. Negotiated Rate	$207.50
Rate for Payer: Aetna Commercial	$157.70
Rate for Payer: Aetna Medicare Advantage	$124.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.83
Rate for Payer: Cigna Commercial	$207.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.90
Rate for Payer: Oxford Commercial	$83.00
Rate for Payer: Qualcare PPO/HMO/WC	$62.25
Rate for Payer: UnitedHealthcare Commercial	$83.00
Rate for Payer: UnitedHealthcare Community & State	$13.11
Rate for Payer: Wellpoint Medicaid Managed Care	$11.79

NEOMYCIN POLY HC OPH SOL

Facility

$206.43

Service Code	NDC 24208063562
Hospital Charge Code	60628020
Hospital Revenue Code	250
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$30.96
Rate for Payer: Qualcare PPO/HMO/WC	$30.96

NEOMYCIN POLY HC OPH SOL

Facility

$206.43

Service Code	NDC 24208063562
Hospital Charge Code	60628020
Hospital Revenue Code	250
Min. Negotiated Rate	$5.86
Max. Negotiated Rate	$103.22
Rate for Payer: Aetna Commercial	$78.44
Rate for Payer: Aetna Medicare Advantage	$61.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.64
Rate for Payer: Cigna Commercial	$103.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.67
Rate for Payer: Oxford Commercial	$41.29
Rate for Payer: Qualcare PPO/HMO/WC	$30.96
Rate for Payer: UnitedHealthcare Commercial	$41.29
Rate for Payer: UnitedHealthcare Community & State	$6.52
Rate for Payer: Wellpoint Medicaid Managed Care	$5.86

NEOMYCIN POLY HC OPH SSP

Facility

$1,253.57

Service Code	NDC 61314064175
Hospital Charge Code	60628021
Hospital Revenue Code	250
Min. Negotiated Rate	$188.04
Max. Negotiated Rate	$188.04
Rate for Payer: Qualcare PPO/HMO/WC	$188.04

NEOMYCIN POLY HC OPH SSP

Facility

$1,253.57

Service Code	NDC 61314064175
Hospital Charge Code	60628021
Hospital Revenue Code	250
Min. Negotiated Rate	$35.60
Max. Negotiated Rate	$626.78
Rate for Payer: Aetna Commercial	$476.36
Rate for Payer: Aetna Medicare Advantage	$376.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$319.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$319.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$319.66
Rate for Payer: Cigna Commercial	$626.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$325.93
Rate for Payer: Oxford Commercial	$250.71
Rate for Payer: Qualcare PPO/HMO/WC	$188.04
Rate for Payer: UnitedHealthcare Commercial	$250.71
Rate for Payer: UnitedHealthcare Community & State	$39.61
Rate for Payer: Wellpoint Medicaid Managed Care	$35.60

NEOMYCIN,SERUM

Facility

$376.00

Service Code	HCPCS 80299
Hospital Charge Code	38473113
Hospital Revenue Code	301
Min. Negotiated Rate	$56.40
Max. Negotiated Rate	$56.40
Rate for Payer: Qualcare PPO/HMO/WC	$56.40

NEOMYCIN,SERUM

Facility

$376.00

Service Code	HCPCS 80299
Hospital Charge Code	38473113
Hospital Revenue Code	301
Min. Negotiated Rate	$9.92
Max. Negotiated Rate	$188.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.62
Rate for Payer: Cigna Commercial	$188.00
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$97.76
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$56.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$10.68

Know your out-of-pocket cost for care.

All Charges