Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

NUT WHITE F/FLASHPAK INSTAL

Facility

$20.00

Hospital Charge Code	270639737
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

NUT WHITE F/FLASHPAK INSTAL

Facility

$20.00

Hospital Charge Code	270639737
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$7.60
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$4.00
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

NV ENDOTRACHEAL TUBE 7MM EMG

Facility

$1,850.00

Hospital Charge Code	270694490
Hospital Revenue Code	272
Min. Negotiated Rate	$52.54
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$481.00
Rate for Payer: Oxford Commercial	$370.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Commercial	$370.00
Rate for Payer: UnitedHealthcare Community & State	$58.46
Rate for Payer: Wellpoint Medicaid Managed Care	$52.54

NV ENDOTRACHEAL TUBE 7MM EMG

Facility

$1,850.00

Hospital Charge Code	270694490
Hospital Revenue Code	272
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$277.50
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

NVM5 EMG ENDOTRACH TUBE 7MM

Facility

$1,850.00

Hospital Charge Code	270694492
Hospital Revenue Code	272
Min. Negotiated Rate	$277.50
Max. Negotiated Rate	$277.50
Rate for Payer: Qualcare PPO/HMO/WC	$277.50

NVM5 EMG ENDOTRACH TUBE 7MM

Facility

$1,850.00

Hospital Charge Code	270694492
Hospital Revenue Code	272
Min. Negotiated Rate	$52.54
Max. Negotiated Rate	$925.00
Rate for Payer: Aetna Commercial	$703.00
Rate for Payer: Aetna Medicare Advantage	$555.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$471.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$471.75
Rate for Payer: Cigna Commercial	$925.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$481.00
Rate for Payer: Oxford Commercial	$370.00
Rate for Payer: Qualcare PPO/HMO/WC	$277.50
Rate for Payer: UnitedHealthcare Commercial	$370.00
Rate for Payer: UnitedHealthcare Community & State	$58.46
Rate for Payer: Wellpoint Medicaid Managed Care	$52.54

NVM5 NEEDLE MODULE MEP EMG

Facility

$5,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270696790
Hospital Revenue Code	272
Min. Negotiated Rate	$825.00
Max. Negotiated Rate	$825.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00

NVM5 NEEDLE MODULE MEP EMG

Facility

$5,500.00

Service Code	HCPCS A4649
Hospital Charge Code	270696790
Hospital Revenue Code	272
Min. Negotiated Rate	$156.20
Max. Negotiated Rate	$2,750.00
Rate for Payer: Aetna Commercial	$2,090.00
Rate for Payer: Aetna Medicare Advantage	$1,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,402.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,402.50
Rate for Payer: Cigna Commercial	$2,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,430.00
Rate for Payer: Oxford Commercial	$1,100.00
Rate for Payer: Qualcare PPO/HMO/WC	$825.00
Rate for Payer: UnitedHealthcare Commercial	$1,100.00
Rate for Payer: UnitedHealthcare Community & State	$173.80
Rate for Payer: Wellpoint Medicaid Managed Care	$156.20

NXGN A/P WDG PRCT TIB PLT SZ 5

Facility

$13,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270686883
Hospital Revenue Code	278
Min. Negotiated Rate	$374.88
Max. Negotiated Rate	$6,600.00
Rate for Payer: Aetna Commercial	$5,016.00
Rate for Payer: Aetna Medicare Advantage	$3,960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,366.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,366.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,640.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,366.00
Rate for Payer: Cigna Commercial	$6,600.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,194.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,980.00
Rate for Payer: UnitedHealthcare Community & State	$417.12
Rate for Payer: Wellpoint Medicaid Managed Care	$374.88

NXGN A/P WDG PRCT TIB PLT SZ 5

Facility

$13,200.00

Service Code	HCPCS C1713
Hospital Charge Code	270686883
Hospital Revenue Code	278
Min. Negotiated Rate	$1,980.00
Max. Negotiated Rate	$3,194.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,640.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,194.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,980.00

NXGN ARTSUR CD3-4 12MM LPSFLX

Facility

$5,862.10

Hospital Charge Code	270668703
Hospital Revenue Code	278
Min. Negotiated Rate	$166.48
Max. Negotiated Rate	$2,931.05
Rate for Payer: Aetna Commercial	$2,227.60
Rate for Payer: Aetna Medicare Advantage	$1,758.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,494.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,494.84
Rate for Payer: Cigna Commercial	$2,931.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32
Rate for Payer: UnitedHealthcare Community & State	$185.24
Rate for Payer: Wellpoint Medicaid Managed Care	$166.48

NXGN ARTSUR CD3-4 12MM LPSFLX

Facility

$5,862.10

Hospital Charge Code	270668703
Hospital Revenue Code	278
Min. Negotiated Rate	$879.32
Max. Negotiated Rate	$1,418.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,172.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,418.63
Rate for Payer: Qualcare PPO/HMO/WC	$879.32

NXGN LCCK ART SURF GRN 23MM

Facility

$12,840.00

Service Code	HCPCS C1713
Hospital Charge Code	270686882
Hospital Revenue Code	278
Min. Negotiated Rate	$1,926.00
Max. Negotiated Rate	$3,107.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,568.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,107.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,926.00

NXGN LCCK ART SURF GRN 23MM

Facility

$12,840.00

Service Code	HCPCS C1713
Hospital Charge Code	270686882
Hospital Revenue Code	278
Min. Negotiated Rate	$364.66
Max. Negotiated Rate	$6,420.00
Rate for Payer: Aetna Commercial	$4,879.20
Rate for Payer: Aetna Medicare Advantage	$3,852.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,274.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,274.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,568.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,274.20
Rate for Payer: Cigna Commercial	$6,420.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,107.28
Rate for Payer: Qualcare PPO/HMO/WC	$1,926.00
Rate for Payer: UnitedHealthcare Community & State	$405.74
Rate for Payer: Wellpoint Medicaid Managed Care	$364.66

Nylon cart cover to fit 1436-3

Facility

$425.00

Hospital Charge Code	270665975
Hospital Revenue Code	270
Min. Negotiated Rate	$63.75
Max. Negotiated Rate	$63.75
Rate for Payer: Qualcare PPO/HMO/WC	$63.75

Nylon cart cover to fit 1436-3

Facility

$425.00

Hospital Charge Code	270665975
Hospital Revenue Code	270
Min. Negotiated Rate	$12.07
Max. Negotiated Rate	$212.50
Rate for Payer: Aetna Commercial	$161.50
Rate for Payer: Aetna Medicare Advantage	$127.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$108.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$108.38
Rate for Payer: Cigna Commercial	$212.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$110.50
Rate for Payer: Oxford Commercial	$85.00
Rate for Payer: Qualcare PPO/HMO/WC	$63.75
Rate for Payer: UnitedHealthcare Commercial	$85.00
Rate for Payer: UnitedHealthcare Community & State	$13.43
Rate for Payer: Wellpoint Medicaid Managed Care	$12.07

NYSTATIN 100000 U/ML UD

Facility

$8.44

Service Code	NDC 121478505
Hospital Charge Code	60628836
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.22
Rate for Payer: Aetna Commercial	$3.21
Rate for Payer: Aetna Medicare Advantage	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.15
Rate for Payer: Cigna Commercial	$4.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.27
Rate for Payer: UnitedHealthcare Commercial	$1.69
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

NYSTATIN 100000 U/ML UD

Facility

$8.44

Service Code	NDC 121478505
Hospital Charge Code	60628836
Hospital Revenue Code	250
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$1.27

NYSTATIN OINT 100MU

Facility

$175.88

Service Code	NDC 472016630
Hospital Charge Code	60628343
Hospital Revenue Code	250
Min. Negotiated Rate	$26.38
Max. Negotiated Rate	$26.38
Rate for Payer: Qualcare PPO/HMO/WC	$26.38

NYSTATIN OINT 100MU

Facility

$175.88

Service Code	NDC 472016630
Hospital Charge Code	60628343
Hospital Revenue Code	250
Min. Negotiated Rate	$4.99
Max. Negotiated Rate	$87.94
Rate for Payer: Aetna Commercial	$66.83
Rate for Payer: Aetna Medicare Advantage	$52.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.85
Rate for Payer: Cigna Commercial	$87.94
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.73
Rate for Payer: Oxford Commercial	$35.18
Rate for Payer: Qualcare PPO/HMO/WC	$26.38
Rate for Payer: UnitedHealthcare Commercial	$35.18
Rate for Payer: UnitedHealthcare Community & State	$5.56
Rate for Payer: Wellpoint Medicaid Managed Care	$4.99

NYSTATIN POWDER 60GM BOTTLE

Facility

$559.25

Service Code	NDC 16714076903
Hospital Charge Code	606390360
Hospital Revenue Code	250
Min. Negotiated Rate	$15.88
Max. Negotiated Rate	$279.62
Rate for Payer: Aetna Commercial	$212.51
Rate for Payer: Aetna Medicare Advantage	$167.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.61
Rate for Payer: Cigna Commercial	$279.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$145.41
Rate for Payer: Oxford Commercial	$111.85
Rate for Payer: Qualcare PPO/HMO/WC	$83.89
Rate for Payer: UnitedHealthcare Commercial	$111.85
Rate for Payer: UnitedHealthcare Community & State	$17.67
Rate for Payer: Wellpoint Medicaid Managed Care	$15.88

NYSTATIN POWDER 60GM BOTTLE

Facility

$559.25

Service Code	NDC 16714076903
Hospital Charge Code	606390360
Hospital Revenue Code	250
Min. Negotiated Rate	$83.89
Max. Negotiated Rate	$83.89
Rate for Payer: Qualcare PPO/HMO/WC	$83.89

NYSTATIN TOPICAL CREAM

Facility

$117.59

Service Code	NDC 51672128901
Hospital Charge Code	60628342
Hospital Revenue Code	250
Min. Negotiated Rate	$3.34
Max. Negotiated Rate	$58.80
Rate for Payer: Aetna Commercial	$44.68
Rate for Payer: Aetna Medicare Advantage	$35.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.99
Rate for Payer: Cigna Commercial	$58.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.57
Rate for Payer: Oxford Commercial	$23.52
Rate for Payer: Qualcare PPO/HMO/WC	$17.64
Rate for Payer: UnitedHealthcare Commercial	$23.52
Rate for Payer: UnitedHealthcare Community & State	$3.72
Rate for Payer: Wellpoint Medicaid Managed Care	$3.34

NYSTATIN TOPICAL CREAM

Facility

$117.59

Service Code	NDC 51672128901
Hospital Charge Code	60628342
Hospital Revenue Code	250
Min. Negotiated Rate	$17.64
Max. Negotiated Rate	$17.64
Rate for Payer: Qualcare PPO/HMO/WC	$17.64

NYSTATIN TRIAMCIN CRM 30GM

Facility

$147.07

Service Code	NDC 75907006044
Hospital Charge Code	6007223
Hospital Revenue Code	251
Min. Negotiated Rate	$4.18
Max. Negotiated Rate	$73.53
Rate for Payer: Aetna Commercial	$55.89
Rate for Payer: Aetna Medicare Advantage	$44.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.50
Rate for Payer: Cigna Commercial	$73.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.24
Rate for Payer: Oxford Commercial	$29.41
Rate for Payer: Qualcare PPO/HMO/WC	$22.06
Rate for Payer: UnitedHealthcare Commercial	$29.41
Rate for Payer: UnitedHealthcare Community & State	$4.65
Rate for Payer: Wellpoint Medicaid Managed Care	$4.18

Know your out-of-pocket cost for care.

All Charges