Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PIN VA LCKG BUTTRESS 1.8x14MM

Facility

$577.85

Hospital Charge Code	270678115
Hospital Revenue Code	278
Min. Negotiated Rate	$16.41
Max. Negotiated Rate	$288.93
Rate for Payer: Aetna Commercial	$219.58
Rate for Payer: Aetna Medicare Advantage	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.35
Rate for Payer: Cigna Commercial	$288.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68
Rate for Payer: UnitedHealthcare Community & State	$18.26
Rate for Payer: Wellpoint Medicaid Managed Care	$16.41

PIN VA LCKG BUTTRESS 1.8x16MM

Facility

$595.20

Service Code	HCPCS C1713
Hospital Charge Code	270677573
Hospital Revenue Code	278
Min. Negotiated Rate	$89.28
Max. Negotiated Rate	$144.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.04
Rate for Payer: Qualcare PPO/HMO/WC	$89.28

PIN VA LCKG BUTTRESS 1.8x16MM

Facility

$595.20

Service Code	HCPCS C1713
Hospital Charge Code	270677573
Hospital Revenue Code	278
Min. Negotiated Rate	$16.90
Max. Negotiated Rate	$297.60
Rate for Payer: Aetna Commercial	$226.18
Rate for Payer: Aetna Medicare Advantage	$178.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.78
Rate for Payer: Cigna Commercial	$297.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.04
Rate for Payer: Qualcare PPO/HMO/WC	$89.28
Rate for Payer: UnitedHealthcare Community & State	$18.81
Rate for Payer: Wellpoint Medicaid Managed Care	$16.90

PIN VA LCKG BUTTRESS 1.8x18MM

Facility

$595.20

Service Code	HCPCS C1713
Hospital Charge Code	270677572
Hospital Revenue Code	278
Min. Negotiated Rate	$89.28
Max. Negotiated Rate	$144.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.04
Rate for Payer: Qualcare PPO/HMO/WC	$89.28

PIN VA LCKG BUTTRESS 1.8x18MM

Facility

$595.20

Service Code	HCPCS C1713
Hospital Charge Code	270677572
Hospital Revenue Code	278
Min. Negotiated Rate	$16.90
Max. Negotiated Rate	$297.60
Rate for Payer: Aetna Commercial	$226.18
Rate for Payer: Aetna Medicare Advantage	$178.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.78
Rate for Payer: Cigna Commercial	$297.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.04
Rate for Payer: Qualcare PPO/HMO/WC	$89.28
Rate for Payer: UnitedHealthcare Community & State	$18.81
Rate for Payer: Wellpoint Medicaid Managed Care	$16.90

PIN VA LCKG BUTTRESS 1.8x20MM

Facility

$595.20

Service Code	HCPCS C1713
Hospital Charge Code	270677130
Hospital Revenue Code	278
Min. Negotiated Rate	$16.90
Max. Negotiated Rate	$297.60
Rate for Payer: Aetna Commercial	$226.18
Rate for Payer: Aetna Medicare Advantage	$178.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.78
Rate for Payer: Cigna Commercial	$297.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.04
Rate for Payer: Qualcare PPO/HMO/WC	$89.28
Rate for Payer: UnitedHealthcare Community & State	$18.81
Rate for Payer: Wellpoint Medicaid Managed Care	$16.90

PIN VA LCKG BUTTRESS 1.8x20MM

Facility

$595.20

Service Code	HCPCS C1713
Hospital Charge Code	270677130
Hospital Revenue Code	278
Min. Negotiated Rate	$89.28
Max. Negotiated Rate	$144.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$119.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$144.04
Rate for Payer: Qualcare PPO/HMO/WC	$89.28

PIN VA LCKG BUTTRESS 1.8x22MM

Facility

$577.85

Hospital Charge Code	270677801
Hospital Revenue Code	278
Min. Negotiated Rate	$86.68
Max. Negotiated Rate	$139.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68

PIN VA LCKG BUTTRESS 1.8x22MM

Facility

$577.85

Hospital Charge Code	270677801
Hospital Revenue Code	278
Min. Negotiated Rate	$16.41
Max. Negotiated Rate	$288.93
Rate for Payer: Aetna Commercial	$219.58
Rate for Payer: Aetna Medicare Advantage	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.35
Rate for Payer: Cigna Commercial	$288.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68
Rate for Payer: UnitedHealthcare Community & State	$18.26
Rate for Payer: Wellpoint Medicaid Managed Care	$16.41

PIN VA LCKG BUTTRESS 1.8x24MM

Facility

$577.85

Hospital Charge Code	270677802
Hospital Revenue Code	278
Min. Negotiated Rate	$86.68
Max. Negotiated Rate	$139.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68

PIN VA LCKG BUTTRESS 1.8x24MM

Facility

$577.85

Hospital Charge Code	270677802
Hospital Revenue Code	278
Min. Negotiated Rate	$16.41
Max. Negotiated Rate	$288.93
Rate for Payer: Aetna Commercial	$219.58
Rate for Payer: Aetna Medicare Advantage	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.35
Rate for Payer: Cigna Commercial	$288.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68
Rate for Payer: UnitedHealthcare Community & State	$18.26
Rate for Payer: Wellpoint Medicaid Managed Care	$16.41

PIN VA LCKG BUTTRESS 1.8x26MM

Facility

$577.85

Hospital Charge Code	270677803
Hospital Revenue Code	278
Min. Negotiated Rate	$16.41
Max. Negotiated Rate	$288.93
Rate for Payer: Aetna Commercial	$219.58
Rate for Payer: Aetna Medicare Advantage	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.35
Rate for Payer: Cigna Commercial	$288.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68
Rate for Payer: UnitedHealthcare Community & State	$18.26
Rate for Payer: Wellpoint Medicaid Managed Care	$16.41

PIN VA LCKG BUTTRESS 1.8x26MM

Facility

$577.85

Hospital Charge Code	270677803
Hospital Revenue Code	278
Min. Negotiated Rate	$86.68
Max. Negotiated Rate	$139.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68

PIN VA LCKG BUTTRESS 1.8x28mm

Facility

$577.85

Service Code	HCPCS C1713
Hospital Charge Code	270680388
Hospital Revenue Code	278
Min. Negotiated Rate	$86.68
Max. Negotiated Rate	$139.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68

PIN VA LCKG BUTTRESS 1.8x28mm

Facility

$577.85

Service Code	HCPCS C1713
Hospital Charge Code	270680388
Hospital Revenue Code	278
Min. Negotiated Rate	$16.41
Max. Negotiated Rate	$288.93
Rate for Payer: Aetna Commercial	$219.58
Rate for Payer: Aetna Medicare Advantage	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.35
Rate for Payer: Cigna Commercial	$288.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68
Rate for Payer: UnitedHealthcare Community & State	$18.26
Rate for Payer: Wellpoint Medicaid Managed Care	$16.41

PIN VA LCKG BUTTRESS 1.8x30MM

Facility

$577.85

Hospital Charge Code	270676422
Hospital Revenue Code	278
Min. Negotiated Rate	$16.41
Max. Negotiated Rate	$288.93
Rate for Payer: Aetna Commercial	$219.58
Rate for Payer: Aetna Medicare Advantage	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.35
Rate for Payer: Cigna Commercial	$288.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68
Rate for Payer: UnitedHealthcare Community & State	$18.26
Rate for Payer: Wellpoint Medicaid Managed Care	$16.41

PIN VA LCKG BUTTRESS 1.8x30MM

Facility

$577.85

Hospital Charge Code	270676422
Hospital Revenue Code	278
Min. Negotiated Rate	$86.68
Max. Negotiated Rate	$139.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68

PIN VA LCKG BUTTRESS 1.8x8MM

Facility

$577.85

Hospital Charge Code	270676421
Hospital Revenue Code	278
Min. Negotiated Rate	$16.41
Max. Negotiated Rate	$288.93
Rate for Payer: Aetna Commercial	$219.58
Rate for Payer: Aetna Medicare Advantage	$173.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$147.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$147.35
Rate for Payer: Cigna Commercial	$288.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68
Rate for Payer: UnitedHealthcare Community & State	$18.26
Rate for Payer: Wellpoint Medicaid Managed Care	$16.41

PIN VA LCKG BUTTRESS 1.8x8MM

Facility

$577.85

Hospital Charge Code	270676421
Hospital Revenue Code	278
Min. Negotiated Rate	$86.68
Max. Negotiated Rate	$139.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$115.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$139.84
Rate for Payer: Qualcare PPO/HMO/WC	$86.68

PIN VERSITOMIC STERILE

Facility

$278.40

Hospital Charge Code	270676802
Hospital Revenue Code	272
Min. Negotiated Rate	$7.91
Max. Negotiated Rate	$139.20
Rate for Payer: Aetna Commercial	$105.79
Rate for Payer: Aetna Medicare Advantage	$83.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$70.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$70.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$70.99
Rate for Payer: Cigna Commercial	$139.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$72.38
Rate for Payer: Oxford Commercial	$55.68
Rate for Payer: Qualcare PPO/HMO/WC	$41.76
Rate for Payer: UnitedHealthcare Commercial	$55.68
Rate for Payer: UnitedHealthcare Community & State	$8.80
Rate for Payer: Wellpoint Medicaid Managed Care	$7.91

PIN VERSITOMIC STERILE

Facility

$278.40

Hospital Charge Code	270676802
Hospital Revenue Code	272
Min. Negotiated Rate	$41.76
Max. Negotiated Rate	$41.76
Rate for Payer: Qualcare PPO/HMO/WC	$41.76

PINWORM EXAM(EG,CELLPH TAPE PR

Facility

$30.00

Service Code	HCPCS 87172
Hospital Charge Code	38475078
Hospital Revenue Code	309
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

PINWORM EXAM(EG,CELLPH TAPE PR

Facility

$30.00

Service Code	HCPCS 87172
Hospital Charge Code	38475078
Hospital Revenue Code	309
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$13.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.49
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: Cigna Medicare Advantage	$4.27
Rate for Payer: Clover Medicare Advantage	$4.06
Rate for Payer: EmblemHealth Commercial	$12.81
Rate for Payer: Humana Medicare Advantage	$4.40
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.27
Rate for Payer: Wellcare Medicare Advantage	$4.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

PIOGLITAZONE 15 MG TAB

Facility

$83.68

Service Code	NDC 64764015104
Hospital Charge Code	60629054
Hospital Revenue Code	250
Min. Negotiated Rate	$12.55
Max. Negotiated Rate	$12.55
Rate for Payer: Qualcare PPO/HMO/WC	$12.55

PIOGLITAZONE 15 MG TAB

Facility

$83.68

Service Code	NDC 64764015104
Hospital Charge Code	60629054
Hospital Revenue Code	250
Min. Negotiated Rate	$2.38
Max. Negotiated Rate	$41.84
Rate for Payer: Aetna Commercial	$31.80
Rate for Payer: Aetna Medicare Advantage	$25.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.34
Rate for Payer: Cigna Commercial	$41.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.76
Rate for Payer: Oxford Commercial	$16.74
Rate for Payer: Qualcare PPO/HMO/WC	$12.55
Rate for Payer: UnitedHealthcare Commercial	$16.74
Rate for Payer: UnitedHealthcare Community & State	$2.64
Rate for Payer: Wellpoint Medicaid Managed Care	$2.38

Know your out-of-pocket cost for care.

All Charges