Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NOVASURE W/SURESOUND DEVICE

Facility

$5,750.00

Hospital Charge Code	270641829
Hospital Revenue Code	272
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$862.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

NOVOFINE NEEDLE

Facility

$18.75

Hospital Charge Code	6063943151
Hospital Revenue Code	270
Min. Negotiated Rate	$2.81
Max. Negotiated Rate	$2.81
Rate for Payer: Qualcare PPO/HMO/WC	$2.81

NOVOFINE NEEDLE

Facility

$18.75

Hospital Charge Code	6063943151
Hospital Revenue Code	270
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$9.38
Rate for Payer: Aetna Commercial	$7.12
Rate for Payer: Aetna Medicare Advantage	$5.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.78
Rate for Payer: Cigna Commercial	$9.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.88
Rate for Payer: Oxford Commercial	$3.75
Rate for Payer: Qualcare PPO/HMO/WC	$2.81
Rate for Payer: UnitedHealthcare Commercial	$3.75
Rate for Payer: UnitedHealthcare Community & State	$0.59
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

NOVOLIN MIX 70/30

Facility

$4.00

Service Code	NDC 169183711
Hospital Charge Code	60635485
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

NOVOLIN MIX 70/30

Facility

$4.00

Service Code	NDC 169183711
Hospital Charge Code	60635485
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NOVOLIN N 100UNITS/ML

Facility

$4.00

Service Code	NDC 169183411
Hospital Charge Code	60633558
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

NOVOLIN N 100UNITS/ML

Facility

$4.00

Service Code	NDC 169183411
Hospital Charge Code	60633558
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NOVOLIN R 100 UN/ML VIAL

Facility

$47.00

Hospital Charge Code	83652583
Hospital Revenue Code	250
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$23.50
Rate for Payer: Aetna Commercial	$17.86
Rate for Payer: Aetna Medicare Advantage	$14.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.98
Rate for Payer: Cigna Commercial	$23.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.22
Rate for Payer: Oxford Commercial	$9.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.05
Rate for Payer: UnitedHealthcare Commercial	$9.40
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.33

NOVOLIN R 100 UN/ML VIAL

Facility

$47.00

Hospital Charge Code	83652583
Hospital Revenue Code	250
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$7.05
Rate for Payer: Qualcare PPO/HMO/WC	$7.05

NOVOLIN R 10ML VIAL (100U/ML)

Facility

$289.20

Hospital Charge Code	606390569
Hospital Revenue Code	250
Min. Negotiated Rate	$8.21
Max. Negotiated Rate	$144.60
Rate for Payer: Aetna Commercial	$109.90
Rate for Payer: Aetna Medicare Advantage	$86.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$73.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$73.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$73.75
Rate for Payer: Cigna Commercial	$144.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.19
Rate for Payer: Oxford Commercial	$57.84
Rate for Payer: Qualcare PPO/HMO/WC	$43.38
Rate for Payer: UnitedHealthcare Commercial	$57.84
Rate for Payer: UnitedHealthcare Community & State	$9.14
Rate for Payer: Wellpoint Medicaid Managed Care	$8.21

NOVOLIN R 10ML VIAL (100U/ML)

Facility

$289.20

Hospital Charge Code	606390569
Hospital Revenue Code	250
Min. Negotiated Rate	$43.38
Max. Negotiated Rate	$43.38
Rate for Payer: Qualcare PPO/HMO/WC	$43.38

NOVOLIN R PER 5 UNITS

Facility

$4.00

Service Code	NDC 169183311
Hospital Charge Code	60632252
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NOVOLIN R PER 5 UNITS

Facility

$4.00

Service Code	NDC 169183311
Hospital Charge Code	60632252
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

NOVOLOG 100UNITS/ML

Facility

$4.00

Service Code	NDC 169330312
Hospital Charge Code	60635373
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NOVOLOG 100UNITS/ML

Facility

$4.00

Service Code	NDC 169330312
Hospital Charge Code	60635373
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

NOVOLOG 70/30 PEN

Facility

$2,472.50

Hospital Charge Code	6063943152
Hospital Revenue Code	250
Min. Negotiated Rate	$370.88
Max. Negotiated Rate	$370.88
Rate for Payer: Qualcare PPO/HMO/WC	$370.88

NOVOLOG 70/30 PEN

Facility

$2,472.50

Hospital Charge Code	6063943152
Hospital Revenue Code	250
Min. Negotiated Rate	$70.22
Max. Negotiated Rate	$1,236.25
Rate for Payer: Aetna Commercial	$939.55
Rate for Payer: Aetna Medicare Advantage	$741.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$630.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$630.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$630.49
Rate for Payer: Cigna Commercial	$1,236.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.85
Rate for Payer: Oxford Commercial	$494.50
Rate for Payer: Qualcare PPO/HMO/WC	$370.88
Rate for Payer: UnitedHealthcare Commercial	$494.50
Rate for Payer: UnitedHealthcare Community & State	$78.13
Rate for Payer: Wellpoint Medicaid Managed Care	$70.22

NOVOLOG MIX 70/30

Facility

$4.00

Service Code	NDC 169368512
Hospital Charge Code	60635483
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

NOVOLOG MIX 70/30

Facility

$4.00

Service Code	NDC 169368512
Hospital Charge Code	60635483
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

NOVOLOG PEN

Facility

$2,472.40

Hospital Charge Code	6063943153
Hospital Revenue Code	250
Min. Negotiated Rate	$370.86
Max. Negotiated Rate	$370.86
Rate for Payer: Qualcare PPO/HMO/WC	$370.86

NOVOLOG PEN

Facility

$2,472.40

Hospital Charge Code	6063943153
Hospital Revenue Code	250
Min. Negotiated Rate	$70.22
Max. Negotiated Rate	$1,236.20
Rate for Payer: Aetna Commercial	$939.51
Rate for Payer: Aetna Medicare Advantage	$741.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$630.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$630.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$630.46
Rate for Payer: Cigna Commercial	$1,236.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.82
Rate for Payer: Oxford Commercial	$494.48
Rate for Payer: Qualcare PPO/HMO/WC	$370.86
Rate for Payer: UnitedHealthcare Commercial	$494.48
Rate for Payer: UnitedHealthcare Community & State	$78.13
Rate for Payer: Wellpoint Medicaid Managed Care	$70.22

NOVOSTITCH CARTIDGE 0

Facility

$2,375.00

Hospital Charge Code	270688717
Hospital Revenue Code	272
Min. Negotiated Rate	$67.45
Max. Negotiated Rate	$1,187.50
Rate for Payer: Aetna Commercial	$902.50
Rate for Payer: Aetna Medicare Advantage	$712.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$605.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$605.62
Rate for Payer: Cigna Commercial	$1,187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$617.50
Rate for Payer: Oxford Commercial	$475.00
Rate for Payer: Qualcare PPO/HMO/WC	$356.25
Rate for Payer: UnitedHealthcare Commercial	$475.00
Rate for Payer: UnitedHealthcare Community & State	$75.05
Rate for Payer: Wellpoint Medicaid Managed Care	$67.45

NOVOSTITCH CARTIDGE 0

Facility

$2,375.00

Hospital Charge Code	270688717
Hospital Revenue Code	272
Min. Negotiated Rate	$356.25
Max. Negotiated Rate	$356.25
Rate for Payer: Qualcare PPO/HMO/WC	$356.25

NOVOSTIT PRO MENISAL RPR SYS 0

Facility

$2,475.00

Hospital Charge Code	270688718
Hospital Revenue Code	272
Min. Negotiated Rate	$371.25
Max. Negotiated Rate	$371.25
Rate for Payer: Qualcare PPO/HMO/WC	$371.25

NOVOSTIT PRO MENISAL RPR SYS 0

Facility

$2,475.00

Hospital Charge Code	270688718
Hospital Revenue Code	272
Min. Negotiated Rate	$70.29
Max. Negotiated Rate	$1,237.50
Rate for Payer: Aetna Commercial	$940.50
Rate for Payer: Aetna Medicare Advantage	$742.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$631.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$631.12
Rate for Payer: Cigna Commercial	$1,237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$643.50
Rate for Payer: Oxford Commercial	$495.00
Rate for Payer: Qualcare PPO/HMO/WC	$371.25
Rate for Payer: UnitedHealthcare Commercial	$495.00
Rate for Payer: UnitedHealthcare Community & State	$78.21
Rate for Payer: Wellpoint Medicaid Managed Care	$70.29

Know your out-of-pocket cost for care.

All Charges