Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PEN BOVIE SMOKE EVAC 125MM

Facility

$34.15

Hospital Charge Code	270677963
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$17.07
Rate for Payer: Aetna Commercial	$12.98
Rate for Payer: Aetna Medicare Advantage	$10.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.71
Rate for Payer: Cigna Commercial	$17.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Oxford Commercial	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$5.12
Rate for Payer: UnitedHealthcare Commercial	$6.83
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

PEN BOVIE SMOKE EVAC 125MM

Facility

$34.15

Hospital Charge Code	270677963
Hospital Revenue Code	272
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$5.12
Rate for Payer: Qualcare PPO/HMO/WC	$5.12

PEN BOVIE SMOKE EVAC 165MM

Facility

$34.15

Hospital Charge Code	270677964
Hospital Revenue Code	272
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$5.12
Rate for Payer: Qualcare PPO/HMO/WC	$5.12

PEN BOVIE SMOKE EVAC 165MM

Facility

$34.15

Hospital Charge Code	270677964
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$17.07
Rate for Payer: Aetna Commercial	$12.98
Rate for Payer: Aetna Medicare Advantage	$10.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.71
Rate for Payer: Cigna Commercial	$17.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Oxford Commercial	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$5.12
Rate for Payer: UnitedHealthcare Commercial	$6.83
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

PEN BOVIE SMOKE EVAC 70MM

Facility

$34.15

Hospital Charge Code	270677962
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$17.07
Rate for Payer: Aetna Commercial	$12.98
Rate for Payer: Aetna Medicare Advantage	$10.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.71
Rate for Payer: Cigna Commercial	$17.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.88
Rate for Payer: Oxford Commercial	$6.83
Rate for Payer: Qualcare PPO/HMO/WC	$5.12
Rate for Payer: UnitedHealthcare Commercial	$6.83
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

PEN BOVIE SMOKE EVAC 70MM

Facility

$34.15

Hospital Charge Code	270677962
Hospital Revenue Code	272
Min. Negotiated Rate	$5.12
Max. Negotiated Rate	$5.12
Rate for Payer: Qualcare PPO/HMO/WC	$5.12

PENCIL ELECTROSURGICAL

Facility

$16.05

Hospital Charge Code	270061165N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$8.03
Rate for Payer: Aetna Commercial	$6.10
Rate for Payer: Aetna Medicare Advantage	$4.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.09
Rate for Payer: Cigna Commercial	$8.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.17
Rate for Payer: Oxford Commercial	$3.21
Rate for Payer: Qualcare PPO/HMO/WC	$2.41
Rate for Payer: UnitedHealthcare Commercial	$3.21
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

PENCIL ELECTROSURGICAL

Facility

$15.56

Hospital Charge Code	270061165S
Hospital Revenue Code	272
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$2.33
Rate for Payer: Qualcare PPO/HMO/WC	$2.33

PENCIL ELECTROSURGICAL

Facility

$16.05

Hospital Charge Code	270061165N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$2.41
Rate for Payer: Qualcare PPO/HMO/WC	$2.41

PENCIL ELECTROSURGICAL

Facility

$15.56

Hospital Charge Code	270061165
Hospital Revenue Code	270
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$7.78
Rate for Payer: Aetna Commercial	$5.91
Rate for Payer: Aetna Medicare Advantage	$4.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.97
Rate for Payer: Cigna Commercial	$7.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.05
Rate for Payer: Oxford Commercial	$3.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.33
Rate for Payer: UnitedHealthcare Commercial	$3.11
Rate for Payer: UnitedHealthcare Community & State	$0.49
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

PENCIL ELECTROSURGICAL

Facility

$15.56

Hospital Charge Code	270061165
Hospital Revenue Code	270
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$2.33
Rate for Payer: Qualcare PPO/HMO/WC	$2.33

PENCIL ELECTROSURGICAL

Facility

$15.56

Hospital Charge Code	270061165S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$7.78
Rate for Payer: Aetna Commercial	$5.91
Rate for Payer: Aetna Medicare Advantage	$4.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.97
Rate for Payer: Cigna Commercial	$7.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.05
Rate for Payer: Oxford Commercial	$3.11
Rate for Payer: Qualcare PPO/HMO/WC	$2.33
Rate for Payer: UnitedHealthcare Commercial	$3.11
Rate for Payer: UnitedHealthcare Community & State	$0.49
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

PENCIL PROBE 9.2MHZ

Facility

$650.00

Hospital Charge Code	270662649
Hospital Revenue Code	272
Min. Negotiated Rate	$18.46
Max. Negotiated Rate	$325.00
Rate for Payer: Aetna Commercial	$247.00
Rate for Payer: Aetna Medicare Advantage	$195.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$165.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$165.75
Rate for Payer: Cigna Commercial	$325.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.00
Rate for Payer: Oxford Commercial	$130.00
Rate for Payer: Qualcare PPO/HMO/WC	$97.50
Rate for Payer: UnitedHealthcare Commercial	$130.00
Rate for Payer: UnitedHealthcare Community & State	$20.54
Rate for Payer: Wellpoint Medicaid Managed Care	$18.46

PENCIL PROBE 9.2MHZ

Facility

$650.00

Hospital Charge Code	270662649
Hospital Revenue Code	272
Min. Negotiated Rate	$97.50
Max. Negotiated Rate	$97.50
Rate for Payer: Qualcare PPO/HMO/WC	$97.50

PENCIL ROCKERSWITCH TROLL

Facility

$33.18

Hospital Charge Code	270651700
Hospital Revenue Code	270
Min. Negotiated Rate	$4.98
Max. Negotiated Rate	$4.98
Rate for Payer: Qualcare PPO/HMO/WC	$4.98

PENCIL ROCKERSWITCH TROLL

Facility

$33.18

Hospital Charge Code	270651700
Hospital Revenue Code	270
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$16.59
Rate for Payer: Aetna Commercial	$12.61
Rate for Payer: Aetna Medicare Advantage	$9.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.46
Rate for Payer: Cigna Commercial	$16.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.63
Rate for Payer: Oxford Commercial	$6.64
Rate for Payer: Qualcare PPO/HMO/WC	$4.98
Rate for Payer: UnitedHealthcare Commercial	$6.64
Rate for Payer: UnitedHealthcare Community & State	$1.05
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

PENCIL SMOKE EVACUATION NEPTUR

Facility

$150.00

Hospital Charge Code	270688981
Hospital Revenue Code	272
Min. Negotiated Rate	$22.50
Max. Negotiated Rate	$22.50
Rate for Payer: Qualcare PPO/HMO/WC	$22.50

PENCIL SMOKE EVACUATION NEPTUR

Facility

$150.00

Hospital Charge Code	270688981
Hospital Revenue Code	272
Min. Negotiated Rate	$4.26
Max. Negotiated Rate	$75.00
Rate for Payer: Aetna Commercial	$57.00
Rate for Payer: Aetna Medicare Advantage	$45.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.25
Rate for Payer: Cigna Commercial	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$39.00
Rate for Payer: Oxford Commercial	$30.00
Rate for Payer: Qualcare PPO/HMO/WC	$22.50
Rate for Payer: UnitedHealthcare Commercial	$30.00
Rate for Payer: UnitedHealthcare Community & State	$4.74
Rate for Payer: Wellpoint Medicaid Managed Care	$4.26

PENEOPLASTY REPR PEMEUM NONOB

Facility

$2,961.70

Service Code	HCPCS 56810
Hospital Charge Code	1600000453
Hospital Revenue Code	360
Min. Negotiated Rate	$84.11
Max. Negotiated Rate	$13,950.60
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
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	$13,950.60
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$770.04
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$444.25
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$93.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$84.11

PENEOPLASTY REPR PEMEUM NONOB

Facility

$2,961.70

Service Code	HCPCS 56810
Hospital Charge Code	1600000453
Hospital Revenue Code	360
Min. Negotiated Rate	$444.25
Max. Negotiated Rate	$444.25
Rate for Payer: Qualcare PPO/HMO/WC	$444.25

PEN G BENZ/PROCAN 1.2 MIL U/2M

Facility

$558.65

Service Code	HCPCS J0558
Hospital Charge Code	6063943226
Hospital Revenue Code	636
Min. Negotiated Rate	$83.80
Max. Negotiated Rate	$135.19
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.19
Rate for Payer: Qualcare PPO/HMO/WC	$83.80

PEN G BENZ/PROCAN 1.2 MIL U/2M

Facility

$558.65

Service Code	HCPCS J0558
Hospital Charge Code	6063943226
Hospital Revenue Code	636
Min. Negotiated Rate	$15.87
Max. Negotiated Rate	$135.19
Rate for Payer: Aetna Commercial	$53.09
Rate for Payer: Aetna Medicare Advantage	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$19.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$20.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.81
Rate for Payer: Cigna Medicare Advantage	$19.52
Rate for Payer: Clover Medicare Advantage	$18.54
Rate for Payer: EmblemHealth Commercial	$58.56
Rate for Payer: Humana Medicare Advantage	$20.11
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$19.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.19
Rate for Payer: Qualcare PPO/HMO/WC	$83.80
Rate for Payer: UnitedHealthcare Community & State	$17.65
Rate for Payer: UnitedHealthcare Medicare Advantage	$19.52
Rate for Payer: Wellcare Medicare Advantage	$19.52
Rate for Payer: Wellpoint Medicaid Managed Care	$15.87

PENICILLIN G 5MU VIAL

Facility

$106.40

Service Code	HCPCS J2540
Hospital Charge Code	60627305
Hospital Revenue Code	636
Min. Negotiated Rate	$15.96
Max. Negotiated Rate	$25.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.96

PENICILLIN G 5MU VIAL

Facility

$106.40

Service Code	HCPCS J2540
Hospital Charge Code	60627305
Hospital Revenue Code	636
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$53.20
Rate for Payer: Aetna Commercial	$40.43
Rate for Payer: Aetna Medicare Advantage	$31.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.13
Rate for Payer: Cigna Commercial	$53.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$25.75
Rate for Payer: Qualcare PPO/HMO/WC	$15.96
Rate for Payer: UnitedHealthcare Community & State	$3.36
Rate for Payer: Wellpoint Medicaid Managed Care	$3.02

PENICILLIN G BENZATHINE 1.2MU

Facility

$700.82

Service Code	HCPCS J0561
Hospital Charge Code	6008973
Hospital Revenue Code	636
Min. Negotiated Rate	$105.12
Max. Negotiated Rate	$169.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.60
Rate for Payer: Qualcare PPO/HMO/WC	$105.12

Know your out-of-pocket cost for care.

All Charges