Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

N. GONORRHOEAE RNA SDA

Facility

$247.00

Service Code	HCPCS 87591
Hospital Charge Code	38479099
Hospital Revenue Code	306
Min. Negotiated Rate	$37.05
Max. Negotiated Rate	$37.05
Rate for Payer: Qualcare PPO/HMO/WC	$37.05

N. GONORRHOEAE RNA SDA

Facility

$247.00

Service Code	HCPCS 87591
Hospital Charge Code	38479099
Hospital Revenue Code	306
Min. Negotiated Rate	$7.01
Max. Negotiated Rate	$156.00
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	$123.50
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	$64.22
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$37.05
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	$7.01

NGT 100MG/250 ML IN D5W

Facility

$197.72

Service Code	NDC 338105102
Hospital Charge Code	6063943380
Hospital Revenue Code	250
Min. Negotiated Rate	$5.62
Max. Negotiated Rate	$98.86
Rate for Payer: Aetna Commercial	$75.13
Rate for Payer: Aetna Medicare Advantage	$59.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.42
Rate for Payer: Cigna Commercial	$98.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.41
Rate for Payer: Oxford Commercial	$39.54
Rate for Payer: Qualcare PPO/HMO/WC	$29.66
Rate for Payer: UnitedHealthcare Commercial	$39.54
Rate for Payer: UnitedHealthcare Community & State	$6.25
Rate for Payer: Wellpoint Medicaid Managed Care	$5.62

NGT 100MG/250 ML IN D5W

Facility

$197.72

Service Code	NDC 338105102
Hospital Charge Code	6063943380
Hospital Revenue Code	250
Min. Negotiated Rate	$29.66
Max. Negotiated Rate	$29.66
Rate for Payer: Qualcare PPO/HMO/WC	$29.66

NIACIN 100 MG TAB

Facility

$4.00

Service Code	NDC 10135018601
Hospital Charge Code	60628483
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NIACIN 100 MG TAB

Facility

$4.00

Service Code	NDC 10135018601
Hospital Charge Code	60628483
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

NIACIN 250MG TABS

Facility

$4.00

Service Code	NDC 904062960
Hospital Charge Code	60635115
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

NIACIN 250MG TABS

Facility

$4.00

Service Code	NDC 904062960
Hospital Charge Code	60635115
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NIACIN 500 MG TABLET

Facility

$13.07

Service Code	NDC 904227260
Hospital Charge Code	606390222
Hospital Revenue Code	250
Min. Negotiated Rate	$0.37
Max. Negotiated Rate	$6.54
Rate for Payer: Aetna Commercial	$4.97
Rate for Payer: Aetna Medicare Advantage	$3.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.33
Rate for Payer: Cigna Commercial	$6.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.40
Rate for Payer: Oxford Commercial	$2.61
Rate for Payer: Qualcare PPO/HMO/WC	$1.96
Rate for Payer: UnitedHealthcare Commercial	$2.61
Rate for Payer: UnitedHealthcare Community & State	$0.41
Rate for Payer: Wellpoint Medicaid Managed Care	$0.37

NIACIN 500 MG TABLET

Facility

$13.07

Service Code	NDC 904227260
Hospital Charge Code	606390222
Hospital Revenue Code	250
Min. Negotiated Rate	$1.96
Max. Negotiated Rate	$1.96
Rate for Payer: Qualcare PPO/HMO/WC	$1.96

NIACIN 50MG TAB

Facility

$4.00

Service Code	NDC 904227060
Hospital Charge Code	6063943148
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NIACIN 50MG TAB

Facility

$4.00

Service Code	NDC 904227060
Hospital Charge Code	6063943148
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

NIACINAMIDE 500 MG TAB

Facility

$4.00

Service Code	NDC 54458065710
Hospital Charge Code	606390054
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NIACINAMIDE 500 MG TAB

Facility

$4.00

Service Code	NDC 54458065710
Hospital Charge Code	606390054
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

NICARDIPINE 25MG/10ML INJ

Facility

$161.94

Service Code	NDC 143968910
Hospital Charge Code	6016398
Hospital Revenue Code	250
Min. Negotiated Rate	$24.29
Max. Negotiated Rate	$24.29
Rate for Payer: Qualcare PPO/HMO/WC	$24.29

NICARDIPINE 25MG/10ML INJ

Facility

$161.94

Service Code	NDC 143968910
Hospital Charge Code	6016398
Hospital Revenue Code	250
Min. Negotiated Rate	$4.60
Max. Negotiated Rate	$80.97
Rate for Payer: Aetna Commercial	$61.54
Rate for Payer: Aetna Medicare Advantage	$48.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$41.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$41.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$41.29
Rate for Payer: Cigna Commercial	$80.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.10
Rate for Payer: Oxford Commercial	$32.39
Rate for Payer: Qualcare PPO/HMO/WC	$24.29
Rate for Payer: UnitedHealthcare Commercial	$32.39
Rate for Payer: UnitedHealthcare Community & State	$5.12
Rate for Payer: Wellpoint Medicaid Managed Care	$4.60

NICKEL

Facility

$172.00

Service Code	HCPCS 83885
Hospital Charge Code	38477174
Hospital Revenue Code	301
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

NICKEL

Facility

$172.00

Service Code	HCPCS 83885
Hospital Charge Code	38477174
Hospital Revenue Code	301
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$66.67
Rate for Payer: Aetna Medicare Advantage	$79.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$88.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$88.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$31.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$88.91
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: Cigna Medicare Advantage	$24.51
Rate for Payer: Clover Medicare Advantage	$23.28
Rate for Payer: EmblemHealth Commercial	$73.53
Rate for Payer: Humana Medicare Advantage	$25.25
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.72
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.51
Rate for Payer: Wellcare Medicare Advantage	$24.51
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

Nicotene 2mg gum

Facility

$4.29

Service Code	NDC 766784340
Hospital Charge Code	6063943350
Hospital Revenue Code	250
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.15
Rate for Payer: Aetna Commercial	$1.63
Rate for Payer: Aetna Medicare Advantage	$1.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.09
Rate for Payer: Cigna Commercial	$2.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.12
Rate for Payer: Oxford Commercial	$0.86
Rate for Payer: Qualcare PPO/HMO/WC	$0.64
Rate for Payer: UnitedHealthcare Commercial	$0.86
Rate for Payer: UnitedHealthcare Community & State	$0.14
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

Nicotene 2mg gum

Facility

$4.29

Service Code	NDC 766784340
Hospital Charge Code	6063943350
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$0.64
Rate for Payer: Qualcare PPO/HMO/WC	$0.64

NICOTINE

Facility

$308.00

Service Code	HCPCS 80323
Hospital Charge Code	38473082
Hospital Revenue Code	301
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$46.20
Rate for Payer: Qualcare PPO/HMO/WC	$46.20

NICOTINE

Facility

$308.00

Service Code	HCPCS 80323
Hospital Charge Code	38473082
Hospital Revenue Code	301
Min. Negotiated Rate	$8.75
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$117.04
Rate for Payer: Aetna Medicare Advantage	$92.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$78.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$78.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$78.54
Rate for Payer: Cigna Commercial	$154.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$80.08
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$46.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.62
Rate for Payer: Wellpoint Medicaid Managed Care	$8.75

NICOTINE 14 MG/24 HR ER

Facility

$32.43

Service Code	NDC 135019503
Hospital Charge Code	60627594
Hospital Revenue Code	250
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$16.21
Rate for Payer: Aetna Commercial	$12.32
Rate for Payer: Aetna Medicare Advantage	$9.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.27
Rate for Payer: Cigna Commercial	$16.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.43
Rate for Payer: Oxford Commercial	$6.49
Rate for Payer: Qualcare PPO/HMO/WC	$4.86
Rate for Payer: UnitedHealthcare Commercial	$6.49
Rate for Payer: UnitedHealthcare Community & State	$1.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

NICOTINE 14 MG/24 HR ER

Facility

$32.43

Service Code	NDC 135019503
Hospital Charge Code	60627594
Hospital Revenue Code	250
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$4.86
Rate for Payer: Qualcare PPO/HMO/WC	$4.86

NICOTINE 21 MG/24 HR ER

Facility

$22.45

Service Code	NDC 766145020
Hospital Charge Code	60627496
Hospital Revenue Code	250
Min. Negotiated Rate	$3.37
Max. Negotiated Rate	$3.37
Rate for Payer: Qualcare PPO/HMO/WC	$3.37

Know your out-of-pocket cost for care.

All Charges