Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

ATAZANAVIR 150 MG CAPSULE

Facility

$171.45

Service Code	NDC 3362412
Hospital Charge Code	60630010
Hospital Revenue Code	250
Min. Negotiated Rate	$25.72
Max. Negotiated Rate	$25.72
Rate for Payer: Qualcare PPO/HMO/WC	$25.72

ATAZANAVIR 150 MG CAPSULE

Facility

$171.45

Service Code	NDC 3362412
Hospital Charge Code	60630010
Hospital Revenue Code	250
Min. Negotiated Rate	$4.87
Max. Negotiated Rate	$85.72
Rate for Payer: Aetna Commercial	$65.15
Rate for Payer: Aetna Medicare Advantage	$51.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.72
Rate for Payer: Cigna Commercial	$85.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.58
Rate for Payer: Oxford Commercial	$34.29
Rate for Payer: Qualcare PPO/HMO/WC	$25.72
Rate for Payer: UnitedHealthcare Commercial	$34.29
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$4.87

ATAZANAVIR 200MG CAP

Facility

$171.45

Service Code	NDC 3363112
Hospital Charge Code	6063943059
Hospital Revenue Code	250
Min. Negotiated Rate	$25.72
Max. Negotiated Rate	$25.72
Rate for Payer: Qualcare PPO/HMO/WC	$25.72

ATAZANAVIR 200MG CAP

Facility

$171.45

Service Code	NDC 3363112
Hospital Charge Code	6063943059
Hospital Revenue Code	250
Min. Negotiated Rate	$4.87
Max. Negotiated Rate	$85.72
Rate for Payer: Aetna Commercial	$65.15
Rate for Payer: Aetna Medicare Advantage	$51.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.72
Rate for Payer: Cigna Commercial	$85.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.58
Rate for Payer: Oxford Commercial	$34.29
Rate for Payer: Qualcare PPO/HMO/WC	$25.72
Rate for Payer: UnitedHealthcare Commercial	$34.29
Rate for Payer: UnitedHealthcare Community & State	$5.42
Rate for Payer: Wellpoint Medicaid Managed Care	$4.87

ATAZANAVIR 300 MG CAPSULE

Facility

$339.62

Service Code	NDC 3362212
Hospital Charge Code	60630009
Hospital Revenue Code	250
Min. Negotiated Rate	$9.65
Max. Negotiated Rate	$169.81
Rate for Payer: Aetna Commercial	$129.06
Rate for Payer: Aetna Medicare Advantage	$101.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$86.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$86.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$86.60
Rate for Payer: Cigna Commercial	$169.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$88.30
Rate for Payer: Oxford Commercial	$67.92
Rate for Payer: Qualcare PPO/HMO/WC	$50.94
Rate for Payer: UnitedHealthcare Commercial	$67.92
Rate for Payer: UnitedHealthcare Community & State	$10.73
Rate for Payer: Wellpoint Medicaid Managed Care	$9.65

ATAZANAVIR 300 MG CAPSULE

Facility

$339.62

Service Code	NDC 3362212
Hospital Charge Code	60630009
Hospital Revenue Code	250
Min. Negotiated Rate	$50.94
Max. Negotiated Rate	$50.94
Rate for Payer: Qualcare PPO/HMO/WC	$50.94

ATEC SCREW INVICTUS MIS FC CC

Facility

$8,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270704129
Hospital Revenue Code	278
Min. Negotiated Rate	$252.05
Max. Negotiated Rate	$4,437.50
Rate for Payer: Aetna Commercial	$3,372.50
Rate for Payer: Aetna Medicare Advantage	$2,662.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,263.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,263.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,775.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,263.12
Rate for Payer: Cigna Commercial	$4,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,147.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.25
Rate for Payer: UnitedHealthcare Community & State	$280.45
Rate for Payer: Wellpoint Medicaid Managed Care	$252.05

ATEC SCREW INVICTUS MIS FC CC

Facility

$8,875.00

Service Code	HCPCS C1713
Hospital Charge Code	270704129
Hospital Revenue Code	278
Min. Negotiated Rate	$1,331.25
Max. Negotiated Rate	$2,147.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,775.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,147.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,331.25

ATEC SYSTEM SIGMA LTP-LIF ILLU

Facility

$6,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270704043
Hospital Revenue Code	278
Min. Negotiated Rate	$177.50
Max. Negotiated Rate	$3,125.00
Rate for Payer: Aetna Commercial	$2,375.00
Rate for Payer: Aetna Medicare Advantage	$1,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,593.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,593.75
Rate for Payer: Cigna Commercial	$3,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50
Rate for Payer: UnitedHealthcare Community & State	$197.50
Rate for Payer: Wellpoint Medicaid Managed Care	$177.50

ATEC SYSTEM SIGMA LTP-LIF ILLU

Facility

$6,250.00

Service Code	HCPCS C1889
Hospital Charge Code	270704043
Hospital Revenue Code	278
Min. Negotiated Rate	$937.50
Max. Negotiated Rate	$1,512.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,512.50
Rate for Payer: Qualcare PPO/HMO/WC	$937.50

ATENOLOL 100MG TAB

Facility

$9.98

Service Code	NDC 51079068501
Hospital Charge Code	6063943060
Hospital Revenue Code	250
Min. Negotiated Rate	$1.50
Max. Negotiated Rate	$1.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.50

ATENOLOL 100MG TAB

Facility

$9.98

Service Code	NDC 51079068501
Hospital Charge Code	6063943060
Hospital Revenue Code	250
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

ATENOLOL 25 MG TAB

Facility

$5.36

Service Code	NDC 51079075920
Hospital Charge Code	6027080
Hospital Revenue Code	251
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.80

ATENOLOL 25 MG TAB

Facility

$5.36

Service Code	NDC 51079075920
Hospital Charge Code	6027080
Hospital Revenue Code	251
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$2.68
Rate for Payer: Aetna Commercial	$2.04
Rate for Payer: Aetna Medicare Advantage	$1.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.37
Rate for Payer: Cigna Commercial	$2.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.39
Rate for Payer: Oxford Commercial	$1.07
Rate for Payer: Qualcare PPO/HMO/WC	$0.80
Rate for Payer: UnitedHealthcare Commercial	$1.07
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

ATENOLOL 50 MG TAB

Facility

$5.96

Service Code	NDC 51079068420
Hospital Charge Code	60627547
Hospital Revenue Code	250
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$0.89
Rate for Payer: Qualcare PPO/HMO/WC	$0.89

ATENOLOL 50 MG TAB

Facility

$5.96

Service Code	NDC 51079068420
Hospital Charge Code	60627547
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$2.98
Rate for Payer: Aetna Commercial	$2.26
Rate for Payer: Aetna Medicare Advantage	$1.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.52
Rate for Payer: Cigna Commercial	$2.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.55
Rate for Payer: Oxford Commercial	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$0.89
Rate for Payer: UnitedHealthcare Commercial	$1.19
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

ATF CANNISTER W/O GEL

Facility

$796.60

Hospital Charge Code	270635002
Hospital Revenue Code	270
Min. Negotiated Rate	$22.62
Max. Negotiated Rate	$398.30
Rate for Payer: Aetna Commercial	$302.71
Rate for Payer: Aetna Medicare Advantage	$238.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$203.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$203.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$203.13
Rate for Payer: Cigna Commercial	$398.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.12
Rate for Payer: Oxford Commercial	$159.32
Rate for Payer: Qualcare PPO/HMO/WC	$119.49
Rate for Payer: UnitedHealthcare Commercial	$159.32
Rate for Payer: UnitedHealthcare Community & State	$25.17
Rate for Payer: Wellpoint Medicaid Managed Care	$22.62

ATF CANNISTER W/O GEL

Facility

$796.60

Hospital Charge Code	270635002
Hospital Revenue Code	270
Min. Negotiated Rate	$119.49
Max. Negotiated Rate	$119.49
Rate for Payer: Qualcare PPO/HMO/WC	$119.49

ATHERECTOMY-FEM POP-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	2709012
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

ATHERECTOMY-FEM POP-LT

Facility

$47,711.75

Service Code	HCPCS 37225LT
Hospital Charge Code	2709012
Hospital Revenue Code	361
Min. Negotiated Rate	$1,355.01
Max. Negotiated Rate	$23,855.88
Rate for Payer: Aetna Commercial	$18,130.47
Rate for Payer: Aetna Medicare Advantage	$14,313.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,166.50
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	$12,166.50
Rate for Payer: Cigna Commercial	$23,855.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,405.06
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76
Rate for Payer: UnitedHealthcare Community & State	$1,507.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,355.01

ATHERECTOMY-FEM POP-RT

Facility

$47,711.75

Service Code	HCPCS 37225RT
Hospital Charge Code	2709014
Hospital Revenue Code	361
Min. Negotiated Rate	$7,156.76
Max. Negotiated Rate	$7,156.76
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76

ATHERECTOMY-FEM POP-RT

Facility

$47,711.75

Service Code	HCPCS 37225RT
Hospital Charge Code	2709014
Hospital Revenue Code	361
Min. Negotiated Rate	$1,355.01
Max. Negotiated Rate	$23,855.88
Rate for Payer: Aetna Commercial	$18,130.47
Rate for Payer: Aetna Medicare Advantage	$14,313.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,166.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,166.50
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	$12,166.50
Rate for Payer: Cigna Commercial	$23,855.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12,405.06
Rate for Payer: Qualcare PPO/HMO/WC	$7,156.76
Rate for Payer: UnitedHealthcare Community & State	$1,507.69
Rate for Payer: Wellpoint Medicaid Managed Care	$1,355.01

ATHEROSCLEROSIS WITH MCC

Facility

$57,269.50

Service Code	MSDRG 302
Min. Negotiated Rate	$17,437.83
Max. Negotiated Rate	$57,269.50
Rate for Payer: Aetna Commercial	$42,646.51
Rate for Payer: Aetna Medicare Advantage	$57,269.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,029.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,029.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18,355.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31,029.60
Rate for Payer: Cigna Commercial	$26,675.80
Rate for Payer: Cigna Medicare Advantage	$18,355.61
Rate for Payer: Clover Medicare Advantage	$17,437.83
Rate for Payer: EmblemHealth Commercial	$55,066.83
Rate for Payer: Humana Medicare Advantage	$18,906.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18,355.61
Rate for Payer: Oxford Commercial	$21,084.09
Rate for Payer: UnitedHealthcare Commercial	$28,221.81
Rate for Payer: UnitedHealthcare Medicare Advantage	$18,355.61
Rate for Payer: Wellcare Medicare Advantage	$18,355.61

ATHEROSCLEROSIS WITHOUT MCC

Facility

$40,733.47

Service Code	MSDRG 303
Min. Negotiated Rate	$11,861.78
Max. Negotiated Rate	$40,733.47
Rate for Payer: Aetna Commercial	$30,869.34
Rate for Payer: Aetna Medicare Advantage	$40,733.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18,285.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18,285.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$13,055.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18,285.30
Rate for Payer: Cigna Commercial	$15,007.65
Rate for Payer: Cigna Medicare Advantage	$13,055.60
Rate for Payer: Clover Medicare Advantage	$12,402.82
Rate for Payer: EmblemHealth Commercial	$39,166.80
Rate for Payer: Humana Medicare Advantage	$13,447.27
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$13,055.60
Rate for Payer: Oxford Commercial	$11,861.78
Rate for Payer: UnitedHealthcare Commercial	$15,877.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$13,055.60
Rate for Payer: Wellcare Medicare Advantage	$13,055.60

ATLAS TOPAZ WAND

Facility

$475.00

Hospital Charge Code	270332603
Hospital Revenue Code	272
Min. Negotiated Rate	$13.49
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$123.50
Rate for Payer: Oxford Commercial	$95.00
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Commercial	$95.00
Rate for Payer: UnitedHealthcare Community & State	$15.01
Rate for Payer: Wellpoint Medicaid Managed Care	$13.49

Know your out-of-pocket cost for care.

All Charges