Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NICOTINE 21 MG/24 HR ER

Facility

$22.45

Service Code	NDC 766145020
Hospital Charge Code	60627496
Hospital Revenue Code	250
Min. Negotiated Rate	$0.64
Max. Negotiated Rate	$11.22
Rate for Payer: Aetna Commercial	$8.53
Rate for Payer: Aetna Medicare Advantage	$6.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.72
Rate for Payer: Cigna Commercial	$11.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.84
Rate for Payer: Oxford Commercial	$4.49
Rate for Payer: Qualcare PPO/HMO/WC	$3.37
Rate for Payer: UnitedHealthcare Commercial	$4.49
Rate for Payer: UnitedHealthcare Community & State	$0.71
Rate for Payer: Wellpoint Medicaid Managed Care	$0.64

NICOTINE 7 MG/24 HR ER

Facility

$42.08

Service Code	NDC 67512407
Hospital Charge Code	60628797
Hospital Revenue Code	250
Min. Negotiated Rate	$6.31
Max. Negotiated Rate	$6.31
Rate for Payer: Qualcare PPO/HMO/WC	$6.31

NICOTINE 7 MG/24 HR ER

Facility

$42.08

Service Code	NDC 67512407
Hospital Charge Code	60628797
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$21.04
Rate for Payer: Aetna Commercial	$15.99
Rate for Payer: Aetna Medicare Advantage	$12.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.73
Rate for Payer: Cigna Commercial	$21.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.94
Rate for Payer: Oxford Commercial	$8.42
Rate for Payer: Qualcare PPO/HMO/WC	$6.31
Rate for Payer: UnitedHealthcare Commercial	$8.42
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

NICOTINE & COTININE, LC/MS/MS

Facility

$434.65

Service Code	HCPCS 80323
Hospital Charge Code	39990242
Hospital Revenue Code	301
Min. Negotiated Rate	$65.20
Max. Negotiated Rate	$65.20
Rate for Payer: Qualcare PPO/HMO/WC	$65.20

NICOTINE & COTININE, LC/MS/MS

Facility

$434.65

Service Code	HCPCS 80323
Hospital Charge Code	39990242
Hospital Revenue Code	301
Min. Negotiated Rate	$12.34
Max. Negotiated Rate	$217.32
Rate for Payer: Aetna Commercial	$165.17
Rate for Payer: Aetna Medicare Advantage	$130.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$110.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$110.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$110.84
Rate for Payer: Cigna Commercial	$217.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.01
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$65.20
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.62
Rate for Payer: Wellpoint Medicaid Managed Care	$12.34

NICOTINE & EXPANDED METABOLITE

Facility

$390.00

Service Code	HCPCS 80323
Hospital Charge Code	3000377
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

NICOTINE & EXPANDED METABOLITE

Facility

$390.00

Service Code	HCPCS 80323
Hospital Charge Code	3000377
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$148.20
Rate for Payer: Aetna Medicare Advantage	$117.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$99.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$99.45
Rate for Payer: Cigna Commercial	$195.00
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	$17.62
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

NICOTINE METABOLITE SCREEN (UA

Facility

$116.00

Service Code	HCPCS 80307
Hospital Charge Code	401380307
Hospital Revenue Code	301
Min. Negotiated Rate	$17.40
Max. Negotiated Rate	$17.40
Rate for Payer: Qualcare PPO/HMO/WC	$17.40

NICOTINE METABOLITE SCREEN (UA

Facility

$116.00

Service Code	HCPCS 80307
Hospital Charge Code	401380307
Hospital Revenue Code	301
Min. Negotiated Rate	$3.29
Max. Negotiated Rate	$225.41
Rate for Payer: Aetna Commercial	$169.02
Rate for Payer: Aetna Medicare Advantage	$201.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$62.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$104.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.41
Rate for Payer: Cigna Commercial	$58.00
Rate for Payer: Cigna Medicare Advantage	$62.14
Rate for Payer: Clover Medicare Advantage	$59.03
Rate for Payer: EmblemHealth Commercial	$186.42
Rate for Payer: Humana Medicare Advantage	$64.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$62.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.16
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$49.71
Rate for Payer: UnitedHealthcare Medicare Advantage	$62.14
Rate for Payer: Wellcare Medicare Advantage	$62.14
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

NIFEDIPINE 10 MG CAP

Facility

$7.17

Service Code	NDC 228249710
Hospital Charge Code	60627589
Hospital Revenue Code	250
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.58
Rate for Payer: Aetna Commercial	$2.72
Rate for Payer: Aetna Medicare Advantage	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.83
Rate for Payer: Cigna Commercial	$3.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.86
Rate for Payer: Oxford Commercial	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.08
Rate for Payer: UnitedHealthcare Commercial	$1.43
Rate for Payer: UnitedHealthcare Community & State	$0.23
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

NIFEDIPINE 10 MG CAP

Facility

$7.17

Service Code	NDC 228249710
Hospital Charge Code	60627589
Hospital Revenue Code	250
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$1.08

NIFEDIPINE 30 MG ER TAB

Facility

$8.84

Service Code	NDC 51079040020
Hospital Charge Code	6009815
Hospital Revenue Code	250
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.42
Rate for Payer: Aetna Commercial	$3.36
Rate for Payer: Aetna Medicare Advantage	$2.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.25
Rate for Payer: Cigna Commercial	$4.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.30
Rate for Payer: Oxford Commercial	$1.77
Rate for Payer: Qualcare PPO/HMO/WC	$1.33
Rate for Payer: UnitedHealthcare Commercial	$1.77
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

NIFEDIPINE 30 MG ER TAB

Facility

$8.84

Service Code	NDC 51079040020
Hospital Charge Code	6009815
Hospital Revenue Code	250
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$1.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.33

NIFEDIPINE 60 MG ER TAB

Facility

$15.34

Service Code	NDC 51079089620
Hospital Charge Code	6009823
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$7.67
Rate for Payer: Aetna Commercial	$5.83
Rate for Payer: Aetna Medicare Advantage	$4.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.91
Rate for Payer: Cigna Commercial	$7.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.99
Rate for Payer: Oxford Commercial	$3.07
Rate for Payer: Qualcare PPO/HMO/WC	$2.30
Rate for Payer: UnitedHealthcare Commercial	$3.07
Rate for Payer: UnitedHealthcare Community & State	$0.48
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

NIFEDIPINE 60 MG ER TAB

Facility

$15.34

Service Code	NDC 51079089620
Hospital Charge Code	6009823
Hospital Revenue Code	250
Min. Negotiated Rate	$2.30
Max. Negotiated Rate	$2.30
Rate for Payer: Qualcare PPO/HMO/WC	$2.30

NIFEDIPINE CC (ADALAT)90MG TAB

Facility

$19.50

Service Code	NDC 378039001
Hospital Charge Code	60630140
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$9.75
Rate for Payer: Aetna Commercial	$7.41
Rate for Payer: Aetna Medicare Advantage	$5.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.97
Rate for Payer: Cigna Commercial	$9.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.07
Rate for Payer: Oxford Commercial	$3.90
Rate for Payer: Qualcare PPO/HMO/WC	$2.92
Rate for Payer: UnitedHealthcare Commercial	$3.90
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

NIFEDIPINE CC (ADALAT)90MG TAB

Facility

$19.50

Service Code	NDC 378039001
Hospital Charge Code	60630140
Hospital Revenue Code	250
Min. Negotiated Rate	$2.92
Max. Negotiated Rate	$2.92
Rate for Payer: Qualcare PPO/HMO/WC	$2.92

NIMODIPINE 30 MG CAP

Facility

$128.84

Service Code	NDC 23155051230
Hospital Charge Code	60628536
Hospital Revenue Code	250
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$64.42
Rate for Payer: Aetna Commercial	$48.96
Rate for Payer: Aetna Medicare Advantage	$38.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.85
Rate for Payer: Cigna Commercial	$64.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.50
Rate for Payer: Oxford Commercial	$25.77
Rate for Payer: Qualcare PPO/HMO/WC	$19.33
Rate for Payer: UnitedHealthcare Commercial	$25.77
Rate for Payer: UnitedHealthcare Community & State	$4.07
Rate for Payer: Wellpoint Medicaid Managed Care	$3.66

NIMODIPINE 30 MG CAP

Facility

$128.84

Service Code	NDC 23155051230
Hospital Charge Code	60628536
Hospital Revenue Code	250
Min. Negotiated Rate	$19.33
Max. Negotiated Rate	$19.33
Rate for Payer: Qualcare PPO/HMO/WC	$19.33

NIMODIPINE ORAL SUSP 60MG/10ML

Facility

$683.40

Service Code	NDC 24338026010
Hospital Charge Code	606390450
Hospital Revenue Code	250
Min. Negotiated Rate	$19.41
Max. Negotiated Rate	$341.70
Rate for Payer: Aetna Commercial	$259.69
Rate for Payer: Aetna Medicare Advantage	$205.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.27
Rate for Payer: Cigna Commercial	$341.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.68
Rate for Payer: Oxford Commercial	$136.68
Rate for Payer: Qualcare PPO/HMO/WC	$102.51
Rate for Payer: UnitedHealthcare Commercial	$136.68
Rate for Payer: UnitedHealthcare Community & State	$21.60
Rate for Payer: Wellpoint Medicaid Managed Care	$19.41

NIMODIPINE ORAL SUSP 60MG/10ML

Facility

$683.40

Service Code	NDC 24338026010
Hospital Charge Code	606390450
Hospital Revenue Code	250
Min. Negotiated Rate	$102.51
Max. Negotiated Rate	$102.51
Rate for Payer: Qualcare PPO/HMO/WC	$102.51

NIPPLE/AREOLA RECONSTRUCTION

Facility

$35,786.50

Service Code	HCPCS 19350
Hospital Charge Code	16000666
Hospital Revenue Code	360
Min. Negotiated Rate	$1,016.34
Max. Negotiated Rate	$16,873.82
Rate for Payer: Aetna Commercial	$12,652.46
Rate for Payer: Aetna Medicare Advantage	$15,071.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16,873.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16,873.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4,651.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16,873.82
Rate for Payer: Cigna Commercial	$9,324.19
Rate for Payer: Cigna Medicare Advantage	$4,651.64
Rate for Payer: Clover Medicare Advantage	$4,419.06
Rate for Payer: EmblemHealth Commercial	$13,954.92
Rate for Payer: Humana Medicare Advantage	$4,791.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4,651.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9,304.49
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$5,367.98
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$1,130.85
Rate for Payer: UnitedHealthcare Medicare Advantage	$4,651.64
Rate for Payer: Wellcare Medicare Advantage	$4,651.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1,016.34

NIPPLE/AREOLA RECONSTRUCTION

Facility

$35,786.50

Service Code	HCPCS 19350
Hospital Charge Code	16000666
Hospital Revenue Code	360
Min. Negotiated Rate	$5,367.98
Max. Negotiated Rate	$5,367.98
Rate for Payer: Qualcare PPO/HMO/WC	$5,367.98

NITINOL PILOT WIRE

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270700461
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

NITINOL PILOT WIRE

Facility

$625.00

Service Code	HCPCS C1769
Hospital Charge Code	270700461
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

Know your out-of-pocket cost for care.

All Charges