Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PARICALCITOL 2 MCG/ML INJ

Facility

$48.71

Service Code	HCPCS J2501
Hospital Charge Code	60635723
Hospital Revenue Code	636
Min. Negotiated Rate	$7.31
Max. Negotiated Rate	$11.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.79
Rate for Payer: Qualcare PPO/HMO/WC	$7.31

PARICALCITOL 2 MCG/ML INJ

Facility

$48.71

Service Code	HCPCS J2501
Hospital Charge Code	60635723
Hospital Revenue Code	636
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$24.36
Rate for Payer: Aetna Commercial	$18.51
Rate for Payer: Aetna Medicare Advantage	$14.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.42
Rate for Payer: Cigna Commercial	$24.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.79
Rate for Payer: Qualcare PPO/HMO/WC	$7.31
Rate for Payer: UnitedHealthcare Community & State	$1.54
Rate for Payer: Wellpoint Medicaid Managed Care	$1.38

PARICALCITOL 5 MCG/ML INJ

Facility

$121.81

Service Code	HCPCS J2501
Hospital Charge Code	60629008
Hospital Revenue Code	636
Min. Negotiated Rate	$18.27
Max. Negotiated Rate	$29.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.48
Rate for Payer: Qualcare PPO/HMO/WC	$18.27

PARICALCITOL 5 MCG/ML INJ

Facility

$121.81

Service Code	HCPCS J2501
Hospital Charge Code	60629008
Hospital Revenue Code	636
Min. Negotiated Rate	$3.46
Max. Negotiated Rate	$60.91
Rate for Payer: Aetna Commercial	$46.29
Rate for Payer: Aetna Medicare Advantage	$36.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.06
Rate for Payer: Cigna Commercial	$60.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.48
Rate for Payer: Qualcare PPO/HMO/WC	$18.27
Rate for Payer: UnitedHealthcare Community & State	$3.85
Rate for Payer: Wellpoint Medicaid Managed Care	$3.46

PARIETAL CELL AB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900364
Hospital Revenue Code	302
Min. Negotiated Rate	$9.64
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
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	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

PARIETAL CELL AB

Facility

$390.00

Service Code	HCPCS 86255
Hospital Charge Code	39900364
Hospital Revenue Code	302
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PARIETAL CELL ANTIBODIES

Facility

$280.00

Service Code	HCPCS 86255
Hospital Charge Code	38476184
Hospital Revenue Code	302
Min. Negotiated Rate	$42.00
Max. Negotiated Rate	$42.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00

PARIETAL CELL ANTIBODIES

Facility

$280.00

Service Code	HCPCS 86255
Hospital Charge Code	38476184
Hospital Revenue Code	302
Min. Negotiated Rate	$7.95
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.78
Rate for Payer: Aetna Medicare Advantage	$39.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$12.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.71
Rate for Payer: Cigna Commercial	$140.00
Rate for Payer: Cigna Medicare Advantage	$12.05
Rate for Payer: Clover Medicare Advantage	$11.45
Rate for Payer: EmblemHealth Commercial	$36.15
Rate for Payer: Humana Medicare Advantage	$12.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$12.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.80
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$42.00
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.64
Rate for Payer: UnitedHealthcare Medicare Advantage	$12.05
Rate for Payer: Wellcare Medicare Advantage	$12.05
Rate for Payer: Wellpoint Medicaid Managed Care	$7.95

PARIETEX MESH 30 CM

Facility

$1,450.00

Hospital Charge Code	270335983
Hospital Revenue Code	278
Min. Negotiated Rate	$217.50
Max. Negotiated Rate	$350.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$217.50

PARIETEX MESH 30 CM

Facility

$1,450.00

Hospital Charge Code	270335983
Hospital Revenue Code	278
Min. Negotiated Rate	$41.18
Max. Negotiated Rate	$725.00
Rate for Payer: Aetna Commercial	$551.00
Rate for Payer: Aetna Medicare Advantage	$435.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$369.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$290.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$369.75
Rate for Payer: Cigna Commercial	$725.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$350.90
Rate for Payer: Qualcare PPO/HMO/WC	$217.50
Rate for Payer: UnitedHealthcare Community & State	$45.82
Rate for Payer: Wellpoint Medicaid Managed Care	$41.18

PARIETEX OPEN PCO12X

Facility

$21.40

Hospital Charge Code	270659390
Hospital Revenue Code	272
Min. Negotiated Rate	$3.21
Max. Negotiated Rate	$3.21
Rate for Payer: Qualcare PPO/HMO/WC	$3.21

PARIETEX OPEN PCO12X

Facility

$21.40

Hospital Charge Code	270659390
Hospital Revenue Code	272
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$10.70
Rate for Payer: Aetna Commercial	$8.13
Rate for Payer: Aetna Medicare Advantage	$6.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.46
Rate for Payer: Cigna Commercial	$10.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.56
Rate for Payer: Oxford Commercial	$4.28
Rate for Payer: Qualcare PPO/HMO/WC	$3.21
Rate for Payer: UnitedHealthcare Commercial	$4.28
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

PARIETEX PLUG 6.5 CM ROUND

Facility

$507.65

Service Code	HCPCS C1781
Hospital Charge Code	270689837
Hospital Revenue Code	278
Min. Negotiated Rate	$14.42
Max. Negotiated Rate	$253.82
Rate for Payer: Aetna Commercial	$192.91
Rate for Payer: Aetna Medicare Advantage	$152.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$129.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$129.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$129.45
Rate for Payer: Cigna Commercial	$253.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.85
Rate for Payer: Qualcare PPO/HMO/WC	$76.15
Rate for Payer: UnitedHealthcare Community & State	$16.04
Rate for Payer: Wellpoint Medicaid Managed Care	$14.42

PARIETEX PLUG 6.5 CM ROUND

Facility

$507.65

Service Code	HCPCS C1781
Hospital Charge Code	270689837
Hospital Revenue Code	278
Min. Negotiated Rate	$76.15
Max. Negotiated Rate	$122.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.85
Rate for Payer: Qualcare PPO/HMO/WC	$76.15

PARIETEX PLUG 8 CM ROUND

Facility

$533.40

Service Code	HCPCS C1781
Hospital Charge Code	270689840
Hospital Revenue Code	278
Min. Negotiated Rate	$80.01
Max. Negotiated Rate	$129.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.08
Rate for Payer: Qualcare PPO/HMO/WC	$80.01

PARIETEX PLUG 8 CM ROUND

Facility

$533.40

Service Code	HCPCS C1781
Hospital Charge Code	270689840
Hospital Revenue Code	278
Min. Negotiated Rate	$15.15
Max. Negotiated Rate	$266.70
Rate for Payer: Aetna Commercial	$202.69
Rate for Payer: Aetna Medicare Advantage	$160.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$136.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$136.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$106.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$136.02
Rate for Payer: Cigna Commercial	$266.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$129.08
Rate for Payer: Qualcare PPO/HMO/WC	$80.01
Rate for Payer: UnitedHealthcare Community & State	$16.86
Rate for Payer: Wellpoint Medicaid Managed Care	$15.15

PARITAL CARE INDIV 75-80 MIN

Facility

$920.00

Service Code	HCPCS 90822
Hospital Charge Code	84310055
Hospital Revenue Code	912
Min. Negotiated Rate	$138.00
Max. Negotiated Rate	$138.00
Rate for Payer: Qualcare PPO/HMO/WC	$138.00

PARITAL CARE INDIV 75-80 MIN

Facility

$920.00

Service Code	HCPCS 90822
Hospital Charge Code	84310055
Hospital Revenue Code	912
Min. Negotiated Rate	$26.13
Max. Negotiated Rate	$460.00
Rate for Payer: Aetna Commercial	$349.60
Rate for Payer: Aetna Medicare Advantage	$276.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$234.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$234.60
Rate for Payer: Cigna Commercial	$460.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$239.20
Rate for Payer: Qualcare PPO/HMO/WC	$138.00
Rate for Payer: UnitedHealthcare Community & State	$29.07
Rate for Payer: Wellpoint Medicaid Managed Care	$26.13

PAROXETINE 10 MG TAB

Facility

$49.51

Service Code	NDC 60505366303
Hospital Charge Code	60628677
Hospital Revenue Code	250
Min. Negotiated Rate	$1.41
Max. Negotiated Rate	$24.75
Rate for Payer: Aetna Commercial	$18.81
Rate for Payer: Aetna Medicare Advantage	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.63
Rate for Payer: Cigna Commercial	$24.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.87
Rate for Payer: Oxford Commercial	$9.90
Rate for Payer: Qualcare PPO/HMO/WC	$7.43
Rate for Payer: UnitedHealthcare Commercial	$9.90
Rate for Payer: UnitedHealthcare Community & State	$1.56
Rate for Payer: Wellpoint Medicaid Managed Care	$1.41

PAROXETINE 10 MG TAB

Facility

$49.51

Service Code	NDC 60505366303
Hospital Charge Code	60628677
Hospital Revenue Code	250
Min. Negotiated Rate	$7.43
Max. Negotiated Rate	$7.43
Rate for Payer: Qualcare PPO/HMO/WC	$7.43

PAROXETINE 20 MG TAB

Facility

$18.29

Service Code	NDC 68382009816
Hospital Charge Code	6017701
Hospital Revenue Code	250
Min. Negotiated Rate	$2.74
Max. Negotiated Rate	$2.74
Rate for Payer: Qualcare PPO/HMO/WC	$2.74

PAROXETINE 20 MG TAB

Facility

$18.29

Service Code	NDC 68382009816
Hospital Charge Code	6017701
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$9.14
Rate for Payer: Aetna Commercial	$6.95
Rate for Payer: Aetna Medicare Advantage	$5.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.66
Rate for Payer: Cigna Commercial	$9.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.76
Rate for Payer: Oxford Commercial	$3.66
Rate for Payer: Qualcare PPO/HMO/WC	$2.74
Rate for Payer: UnitedHealthcare Commercial	$3.66
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.52

PAROXETINE 30 MG TAB

Facility

$53.27

Service Code	NDC 60505366503
Hospital Charge Code	60627774
Hospital Revenue Code	250
Min. Negotiated Rate	$1.51
Max. Negotiated Rate	$26.64
Rate for Payer: Aetna Commercial	$20.24
Rate for Payer: Aetna Medicare Advantage	$15.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.58
Rate for Payer: Cigna Commercial	$26.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.85
Rate for Payer: Oxford Commercial	$10.65
Rate for Payer: Qualcare PPO/HMO/WC	$7.99
Rate for Payer: UnitedHealthcare Commercial	$10.65
Rate for Payer: UnitedHealthcare Community & State	$1.68
Rate for Payer: Wellpoint Medicaid Managed Care	$1.51

PAROXETINE 30 MG TAB

Facility

$53.27

Service Code	NDC 60505366503
Hospital Charge Code	60627774
Hospital Revenue Code	250
Min. Negotiated Rate	$7.99
Max. Negotiated Rate	$7.99
Rate for Payer: Qualcare PPO/HMO/WC	$7.99

PART EXC BONE; DISTAL PHALANX

Facility

$17,164.20

Service Code	HCPCS 26236
Hospital Charge Code	16000555
Hospital Revenue Code	360
Min. Negotiated Rate	$2,574.63
Max. Negotiated Rate	$2,574.63
Rate for Payer: Qualcare PPO/HMO/WC	$2,574.63

Know your out-of-pocket cost for care.

All Charges