Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PAD TRENDELENBURG/ TABLE GEL

Facility

$255.04

Hospital Charge Code	270664519
Hospital Revenue Code	270
Min. Negotiated Rate	$7.24
Max. Negotiated Rate	$127.52
Rate for Payer: Aetna Commercial	$96.92
Rate for Payer: Aetna Medicare Advantage	$76.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$65.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$65.04
Rate for Payer: Cigna Commercial	$127.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.31
Rate for Payer: Oxford Commercial	$51.01
Rate for Payer: Qualcare PPO/HMO/WC	$38.26
Rate for Payer: UnitedHealthcare Commercial	$51.01
Rate for Payer: UnitedHealthcare Community & State	$8.06
Rate for Payer: Wellpoint Medicaid Managed Care	$7.24

PAD VL ELECTRODE

Facility

$13.98

Hospital Charge Code	270061155
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$6.99
Rate for Payer: Aetna Commercial	$5.31
Rate for Payer: Aetna Medicare Advantage	$4.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.56
Rate for Payer: Cigna Commercial	$6.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.63
Rate for Payer: Oxford Commercial	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.10
Rate for Payer: UnitedHealthcare Commercial	$2.80
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

PAD VL ELECTRODE

Facility

$13.98

Hospital Charge Code	270061155
Hospital Revenue Code	272
Min. Negotiated Rate	$2.10
Max. Negotiated Rate	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$2.10

PAI-1

Facility

$897.05

Service Code	HCPCS 85415
Hospital Charge Code	401048415
Hospital Revenue Code	301
Min. Negotiated Rate	$13.75
Max. Negotiated Rate	$448.52
Rate for Payer: Aetna Commercial	$46.76
Rate for Payer: Aetna Medicare Advantage	$55.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.36
Rate for Payer: Cigna Commercial	$448.52
Rate for Payer: Cigna Medicare Advantage	$17.19
Rate for Payer: Clover Medicare Advantage	$16.33
Rate for Payer: EmblemHealth Commercial	$51.57
Rate for Payer: Humana Medicare Advantage	$17.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$233.23
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$134.56
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.75
Rate for Payer: UnitedHealthcare Medicare Advantage	$17.19
Rate for Payer: Wellcare Medicare Advantage	$17.19
Rate for Payer: Wellpoint Medicaid Managed Care	$25.48

PAI-1

Facility

$897.05

Service Code	HCPCS 85415
Hospital Charge Code	401048415
Hospital Revenue Code	301
Min. Negotiated Rate	$134.56
Max. Negotiated Rate	$134.56
Rate for Payer: Qualcare PPO/HMO/WC	$134.56

PAIN,MEPERIDINE,QN,U

Facility

$133.70

Service Code	HCPCS 80300
Hospital Charge Code	39900114
Hospital Revenue Code	301
Min. Negotiated Rate	$3.80
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$50.81
Rate for Payer: Aetna Medicare Advantage	$40.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.09
Rate for Payer: Cigna Commercial	$66.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.76
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$20.05
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.22
Rate for Payer: Wellpoint Medicaid Managed Care	$3.80

PAIN,MEPERIDINE,QN,U

Facility

$133.70

Service Code	HCPCS 80300
Hospital Charge Code	39900114
Hospital Revenue Code	301
Min. Negotiated Rate	$20.05
Max. Negotiated Rate	$20.05
Rate for Payer: Qualcare PPO/HMO/WC	$20.05

PAK INTREPID ULTRASLEEVE .9MM

Facility

$1,090.00

Hospital Charge Code	270670985
Hospital Revenue Code	272
Min. Negotiated Rate	$163.50
Max. Negotiated Rate	$163.50
Rate for Payer: Qualcare PPO/HMO/WC	$163.50

PAK INTREPID ULTRASLEEVE .9MM

Facility

$1,090.00

Hospital Charge Code	270670985
Hospital Revenue Code	272
Min. Negotiated Rate	$30.96
Max. Negotiated Rate	$545.00
Rate for Payer: Aetna Commercial	$414.20
Rate for Payer: Aetna Medicare Advantage	$327.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$277.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$277.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$277.95
Rate for Payer: Cigna Commercial	$545.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$283.40
Rate for Payer: Oxford Commercial	$218.00
Rate for Payer: Qualcare PPO/HMO/WC	$163.50
Rate for Payer: UnitedHealthcare Commercial	$218.00
Rate for Payer: UnitedHealthcare Community & State	$34.44
Rate for Payer: Wellpoint Medicaid Managed Care	$30.96

PALACO BONE CEMENT

Facility

$885.00

Hospital Charge Code	270657659
Hospital Revenue Code	278
Min. Negotiated Rate	$132.75
Max. Negotiated Rate	$214.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: Qualcare PPO/HMO/WC	$132.75

PALACO BONE CEMENT

Facility

$885.00

Hospital Charge Code	270657659
Hospital Revenue Code	278
Min. Negotiated Rate	$25.13
Max. Negotiated Rate	$442.50
Rate for Payer: Aetna Commercial	$336.30
Rate for Payer: Aetna Medicare Advantage	$265.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$225.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$177.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$225.68
Rate for Payer: Cigna Commercial	$442.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$214.17
Rate for Payer: Qualcare PPO/HMO/WC	$132.75
Rate for Payer: UnitedHealthcare Community & State	$27.97
Rate for Payer: Wellpoint Medicaid Managed Care	$25.13

PALACO R 1CX40 CEMENT

Facility

$405.00

Service Code	HCPCS C1713
Hospital Charge Code	270635157
Hospital Revenue Code	278
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$98.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

PALACO R 1CX40 CEMENT

Facility

$405.00

Service Code	HCPCS C1713
Hospital Charge Code	270635157
Hospital Revenue Code	278
Min. Negotiated Rate	$11.50
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$153.90
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$81.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75
Rate for Payer: UnitedHealthcare Community & State	$12.80
Rate for Payer: Wellpoint Medicaid Managed Care	$11.50

PALACOS R+G 1X40 SINGLE (W GEN

Facility

$2,000.05

Hospital Charge Code	270657051
Hospital Revenue Code	278
Min. Negotiated Rate	$56.80
Max. Negotiated Rate	$1,000.02
Rate for Payer: Aetna Commercial	$760.02
Rate for Payer: Aetna Medicare Advantage	$600.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$510.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$510.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$510.01
Rate for Payer: Cigna Commercial	$1,000.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.01
Rate for Payer: Qualcare PPO/HMO/WC	$300.01
Rate for Payer: UnitedHealthcare Community & State	$63.20
Rate for Payer: Wellpoint Medicaid Managed Care	$56.80

PALACOS R+G 1X40 SINGLE (W GEN

Facility

$2,000.05

Hospital Charge Code	270657051
Hospital Revenue Code	278
Min. Negotiated Rate	$300.01
Max. Negotiated Rate	$484.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$400.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$484.01
Rate for Payer: Qualcare PPO/HMO/WC	$300.01

PALACOS R+G 1X40 SINGLE WITH G

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270657049
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

PALACOS R+G 1X40 SINGLE WITH G

Facility

$1,500.00

Service Code	HCPCS C1713
Hospital Charge Code	270657049
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

PALIPERIDONE 1.5MG ER TABLETS

Facility

$204.48

Service Code	NDC 10147095103
Hospital Charge Code	606390238
Hospital Revenue Code	250
Min. Negotiated Rate	$30.67
Max. Negotiated Rate	$30.67
Rate for Payer: Qualcare PPO/HMO/WC	$30.67

PALIPERIDONE 1.5MG ER TABLETS

Facility

$204.48

Service Code	NDC 10147095103
Hospital Charge Code	606390238
Hospital Revenue Code	250
Min. Negotiated Rate	$5.81
Max. Negotiated Rate	$102.24
Rate for Payer: Aetna Commercial	$77.70
Rate for Payer: Aetna Medicare Advantage	$61.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.14
Rate for Payer: Cigna Commercial	$102.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$53.16
Rate for Payer: Oxford Commercial	$40.90
Rate for Payer: Qualcare PPO/HMO/WC	$30.67
Rate for Payer: UnitedHealthcare Commercial	$40.90
Rate for Payer: UnitedHealthcare Community & State	$6.46
Rate for Payer: Wellpoint Medicaid Managed Care	$5.81

PALIPERIDONE 3MG TAB

Facility

$154.70

Service Code	NDC 35356045030
Hospital Charge Code	6063943156
Hospital Revenue Code	250
Min. Negotiated Rate	$23.20
Max. Negotiated Rate	$23.20
Rate for Payer: Qualcare PPO/HMO/WC	$23.20

PALIPERIDONE 3MG TAB

Facility

$154.70

Service Code	NDC 35356045030
Hospital Charge Code	6063943156
Hospital Revenue Code	250
Min. Negotiated Rate	$4.39
Max. Negotiated Rate	$77.35
Rate for Payer: Aetna Commercial	$58.79
Rate for Payer: Aetna Medicare Advantage	$46.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.45
Rate for Payer: Cigna Commercial	$77.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.22
Rate for Payer: Oxford Commercial	$30.94
Rate for Payer: Qualcare PPO/HMO/WC	$23.20
Rate for Payer: UnitedHealthcare Commercial	$30.94
Rate for Payer: UnitedHealthcare Community & State	$4.89
Rate for Payer: Wellpoint Medicaid Managed Care	$4.39

PALIPERIDONE 6MG TAB

Facility

$323.74

Service Code	NDC 50458055101
Hospital Charge Code	6063943157
Hospital Revenue Code	250
Min. Negotiated Rate	$9.19
Max. Negotiated Rate	$161.87
Rate for Payer: Aetna Commercial	$123.02
Rate for Payer: Aetna Medicare Advantage	$97.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$82.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$82.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$82.55
Rate for Payer: Cigna Commercial	$161.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.17
Rate for Payer: Oxford Commercial	$64.75
Rate for Payer: Qualcare PPO/HMO/WC	$48.56
Rate for Payer: UnitedHealthcare Commercial	$64.75
Rate for Payer: UnitedHealthcare Community & State	$10.23
Rate for Payer: Wellpoint Medicaid Managed Care	$9.19

PALIPERIDONE 6MG TAB

Facility

$323.74

Service Code	NDC 50458055101
Hospital Charge Code	6063943157
Hospital Revenue Code	250
Min. Negotiated Rate	$48.56
Max. Negotiated Rate	$48.56
Rate for Payer: Qualcare PPO/HMO/WC	$48.56

PALIVIZUMAB 50 MG/0.5 ML ML

Facility

$10,511.16

Service Code	NDC 60574411401
Hospital Charge Code	6063943225
Hospital Revenue Code	250
Min. Negotiated Rate	$1,576.67
Max. Negotiated Rate	$1,576.67
Rate for Payer: Qualcare PPO/HMO/WC	$1,576.67

PALIVIZUMAB 50 MG/0.5 ML ML

Facility

$10,511.16

Service Code	NDC 60574411401
Hospital Charge Code	6063943225
Hospital Revenue Code	250
Min. Negotiated Rate	$298.52
Max. Negotiated Rate	$5,255.58
Rate for Payer: Aetna Commercial	$3,994.24
Rate for Payer: Aetna Medicare Advantage	$3,153.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,680.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,680.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,680.35
Rate for Payer: Cigna Commercial	$5,255.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,732.90
Rate for Payer: Oxford Commercial	$2,102.23
Rate for Payer: Qualcare PPO/HMO/WC	$1,576.67
Rate for Payer: UnitedHealthcare Commercial	$2,102.23
Rate for Payer: UnitedHealthcare Community & State	$332.15
Rate for Payer: Wellpoint Medicaid Managed Care	$298.52

Know your out-of-pocket cost for care.

All Charges