Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PATTIES SURGICAL .75IN X.75IN

Facility

$67.90

Hospital Charge Code	270664336
Hospital Revenue Code	270
Min. Negotiated Rate	$10.19
Max. Negotiated Rate	$10.19
Rate for Payer: Qualcare PPO/HMO/WC	$10.19

PATTIES SURGICAL .75IN X.75IN

Facility

$67.90

Hospital Charge Code	270664336
Hospital Revenue Code	270
Min. Negotiated Rate	$1.93
Max. Negotiated Rate	$33.95
Rate for Payer: Aetna Commercial	$25.80
Rate for Payer: Aetna Medicare Advantage	$20.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.31
Rate for Payer: Cigna Commercial	$33.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.65
Rate for Payer: Oxford Commercial	$13.58
Rate for Payer: Qualcare PPO/HMO/WC	$10.19
Rate for Payer: UnitedHealthcare Commercial	$13.58
Rate for Payer: UnitedHealthcare Community & State	$2.15
Rate for Payer: Wellpoint Medicaid Managed Care	$1.93

PATTIES SURG X-RAY 1/2x3 10/PK

Facility

$72.50

Hospital Charge Code	270656088
Hospital Revenue Code	271
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$36.25
Rate for Payer: Aetna Commercial	$27.55
Rate for Payer: Aetna Medicare Advantage	$21.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.49
Rate for Payer: Cigna Commercial	$36.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.85
Rate for Payer: Oxford Commercial	$14.50
Rate for Payer: Qualcare PPO/HMO/WC	$10.88
Rate for Payer: UnitedHealthcare Commercial	$14.50
Rate for Payer: UnitedHealthcare Community & State	$2.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

PATTIES SURG X-RAY 1/2x3 10/PK

Facility

$72.50

Hospital Charge Code	270656088
Hospital Revenue Code	271
Min. Negotiated Rate	$10.88
Max. Negotiated Rate	$10.88
Rate for Payer: Qualcare PPO/HMO/WC	$10.88

PAXIL 12.5MG TAB

Facility

$37.39

Service Code	NDC 60505367303
Hospital Charge Code	60635469
Hospital Revenue Code	250
Min. Negotiated Rate	$5.61
Max. Negotiated Rate	$5.61
Rate for Payer: Qualcare PPO/HMO/WC	$5.61

PAXIL 12.5MG TAB

Facility

$37.39

Service Code	NDC 60505367303
Hospital Charge Code	60635469
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$18.70
Rate for Payer: Aetna Commercial	$14.21
Rate for Payer: Aetna Medicare Advantage	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.53
Rate for Payer: Cigna Commercial	$18.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.72
Rate for Payer: Oxford Commercial	$7.48
Rate for Payer: Qualcare PPO/HMO/WC	$5.61
Rate for Payer: UnitedHealthcare Commercial	$7.48
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

PAXIL 25MG TAB

Facility

$38.99

Service Code	NDC 378200493
Hospital Charge Code	60635470
Hospital Revenue Code	250
Min. Negotiated Rate	$1.11
Max. Negotiated Rate	$19.50
Rate for Payer: Aetna Commercial	$14.82
Rate for Payer: Aetna Medicare Advantage	$11.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.94
Rate for Payer: Cigna Commercial	$19.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.14
Rate for Payer: Oxford Commercial	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$5.85
Rate for Payer: UnitedHealthcare Commercial	$7.80
Rate for Payer: UnitedHealthcare Community & State	$1.23
Rate for Payer: Wellpoint Medicaid Managed Care	$1.11

PAXIL 25MG TAB

Facility

$38.99

Service Code	NDC 378200493
Hospital Charge Code	60635470
Hospital Revenue Code	250
Min. Negotiated Rate	$5.85
Max. Negotiated Rate	$5.85
Rate for Payer: Qualcare PPO/HMO/WC	$5.85

PAXIL 37.5 MG TAB

Facility

$62.78

Service Code	NDC 60505367003
Hospital Charge Code	60635471
Hospital Revenue Code	250
Min. Negotiated Rate	$9.42
Max. Negotiated Rate	$9.42
Rate for Payer: Qualcare PPO/HMO/WC	$9.42

PAXIL 37.5 MG TAB

Facility

$62.78

Service Code	NDC 60505367003
Hospital Charge Code	60635471
Hospital Revenue Code	250
Min. Negotiated Rate	$1.78
Max. Negotiated Rate	$31.39
Rate for Payer: Aetna Commercial	$23.86
Rate for Payer: Aetna Medicare Advantage	$18.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.01
Rate for Payer: Cigna Commercial	$31.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.32
Rate for Payer: Oxford Commercial	$12.56
Rate for Payer: Qualcare PPO/HMO/WC	$9.42
Rate for Payer: UnitedHealthcare Commercial	$12.56
Rate for Payer: UnitedHealthcare Community & State	$1.98
Rate for Payer: Wellpoint Medicaid Managed Care	$1.78

PAXLOVID TABLETS 300MG 100MG D

Facility

$1,167.81

Service Code	NDC 69532103
Hospital Charge Code	6063943397
Hospital Revenue Code	250
Min. Negotiated Rate	$175.17
Max. Negotiated Rate	$175.17
Rate for Payer: Qualcare PPO/HMO/WC	$175.17

PAXLOVID TABLETS 300MG 100MG D

Facility

$1,167.81

Service Code	NDC 69532103
Hospital Charge Code	6063943397
Hospital Revenue Code	250
Min. Negotiated Rate	$33.17
Max. Negotiated Rate	$583.90
Rate for Payer: Aetna Commercial	$443.77
Rate for Payer: Aetna Medicare Advantage	$350.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$297.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$297.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$297.79
Rate for Payer: Cigna Commercial	$583.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$303.63
Rate for Payer: Oxford Commercial	$233.56
Rate for Payer: Qualcare PPO/HMO/WC	$175.17
Rate for Payer: UnitedHealthcare Commercial	$233.56
Rate for Payer: UnitedHealthcare Community & State	$36.90
Rate for Payer: Wellpoint Medicaid Managed Care	$33.17

PCK CSTM GYN LAP AVIBMBM009-08

Facility

$194.95

Hospital Charge Code	270642268
Hospital Revenue Code	272
Min. Negotiated Rate	$29.24
Max. Negotiated Rate	$29.24
Rate for Payer: Qualcare PPO/HMO/WC	$29.24

PCK CSTM GYN LAP AVIBMBM009-08

Facility

$194.95

Hospital Charge Code	270642268
Hospital Revenue Code	272
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$97.47
Rate for Payer: Aetna Commercial	$74.08
Rate for Payer: Aetna Medicare Advantage	$58.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.71
Rate for Payer: Cigna Commercial	$97.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.69
Rate for Payer: Oxford Commercial	$38.99
Rate for Payer: Qualcare PPO/HMO/WC	$29.24
Rate for Payer: UnitedHealthcare Commercial	$38.99
Rate for Payer: UnitedHealthcare Community & State	$6.16
Rate for Payer: Wellpoint Medicaid Managed Care	$5.54

PCP, URINE

Facility

$103.00

Service Code	HCPCS 83992
Hospital Charge Code	38472504
Hospital Revenue Code	301
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$39.14
Rate for Payer: Aetna Medicare Advantage	$30.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$26.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$29.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$26.27
Rate for Payer: Cigna Commercial	$51.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.78
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$18.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.93

PCP, URINE

Facility

$103.00

Service Code	HCPCS 83992
Hospital Charge Code	38472504
Hospital Revenue Code	301
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$15.45
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

PD-IT IRRIGATION TUBING

Facility

$705.55

Hospital Charge Code	270699126
Hospital Revenue Code	272
Min. Negotiated Rate	$105.83
Max. Negotiated Rate	$105.83
Rate for Payer: Qualcare PPO/HMO/WC	$105.83

PD-IT IRRIGATION TUBING

Facility

$705.55

Hospital Charge Code	270699126
Hospital Revenue Code	272
Min. Negotiated Rate	$20.04
Max. Negotiated Rate	$352.77
Rate for Payer: Aetna Commercial	$268.11
Rate for Payer: Aetna Medicare Advantage	$211.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$179.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$179.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$179.92
Rate for Payer: Cigna Commercial	$352.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$183.44
Rate for Payer: Oxford Commercial	$141.11
Rate for Payer: Qualcare PPO/HMO/WC	$105.83
Rate for Payer: UnitedHealthcare Commercial	$141.11
Rate for Payer: UnitedHealthcare Community & State	$22.30
Rate for Payer: Wellpoint Medicaid Managed Care	$20.04

PEAK FLOW METER ASTHMA CHECK

Facility

$37.30

Hospital Charge Code	270643983
Hospital Revenue Code	270
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$18.65
Rate for Payer: Aetna Commercial	$14.17
Rate for Payer: Aetna Medicare Advantage	$11.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.51
Rate for Payer: Cigna Commercial	$18.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.70
Rate for Payer: Oxford Commercial	$7.46
Rate for Payer: Qualcare PPO/HMO/WC	$5.59
Rate for Payer: UnitedHealthcare Commercial	$7.46
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

PEAK FLOW METER ASTHMA CHECK

Facility

$37.30

Hospital Charge Code	270643983
Hospital Revenue Code	270
Min. Negotiated Rate	$5.59
Max. Negotiated Rate	$5.59
Rate for Payer: Qualcare PPO/HMO/WC	$5.59

PEAK FLOW TREATMENT

Facility

$10,357.02

Service Code	HCPCS 94150
Hospital Charge Code	9500589
Hospital Revenue Code	460
Min. Negotiated Rate	$1,553.55
Max. Negotiated Rate	$1,553.55
Rate for Payer: Qualcare PPO/HMO/WC	$1,553.55

PEAK FLOW TREATMENT

Facility

$10,357.02

Service Code	HCPCS 94150
Hospital Charge Code	9500589
Hospital Revenue Code	460
Min. Negotiated Rate	$71.50
Max. Negotiated Rate	$2,770.00
Rate for Payer: Aetna Commercial	$415.81
Rate for Payer: Aetna Medicare Advantage	$495.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$554.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$554.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$152.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$71.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$554.54
Rate for Payer: Cigna Commercial	$306.43
Rate for Payer: Cigna Medicare Advantage	$152.87
Rate for Payer: Clover Medicare Advantage	$145.23
Rate for Payer: EmblemHealth Commercial	$458.61
Rate for Payer: Humana Medicare Advantage	$157.46
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$152.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,692.83
Rate for Payer: Oxford Commercial	$2,184.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,553.55
Rate for Payer: UnitedHealthcare Commercial	$2,770.00
Rate for Payer: UnitedHealthcare Community & State	$327.28
Rate for Payer: UnitedHealthcare Medicare Advantage	$152.87
Rate for Payer: Wellcare Medicare Advantage	$152.87
Rate for Payer: Wellpoint Medicaid Managed Care	$294.14

PEANUT ENDOSCOPIC DEVICE 5MM

Facility

$99.75

Hospital Charge Code	270660429
Hospital Revenue Code	272
Min. Negotiated Rate	$14.96
Max. Negotiated Rate	$14.96
Rate for Payer: Qualcare PPO/HMO/WC	$14.96

PEANUT ENDOSCOPIC DEVICE 5MM

Facility

$99.75

Hospital Charge Code	270660429
Hospital Revenue Code	272
Min. Negotiated Rate	$2.83
Max. Negotiated Rate	$49.88
Rate for Payer: Aetna Commercial	$37.91
Rate for Payer: Aetna Medicare Advantage	$29.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.44
Rate for Payer: Cigna Commercial	$49.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.93
Rate for Payer: Oxford Commercial	$19.95
Rate for Payer: Qualcare PPO/HMO/WC	$14.96
Rate for Payer: UnitedHealthcare Commercial	$19.95
Rate for Payer: UnitedHealthcare Community & State	$3.15
Rate for Payer: Wellpoint Medicaid Managed Care	$2.83

PEANUT (F13) IGE

Facility

$390.00

Service Code	HCPCS 86003
Hospital Charge Code	39900353
Hospital Revenue Code	305
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

Know your out-of-pocket cost for care.

All Charges