Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

POWER PORT DUO IMPLANT (BARD

Facility

$3,980.00

Service Code	HCPCS C1788
Hospital Charge Code	270660216
Hospital Revenue Code	278
Min. Negotiated Rate	$597.00
Max. Negotiated Rate	$963.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$796.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$963.16
Rate for Payer: Qualcare PPO/HMO/WC	$597.00

POWERPORT VUE IMPL MRI 8F

Facility

$15,653.00

Service Code	HCPCS C1788
Hospital Charge Code	270698817
Hospital Revenue Code	278
Min. Negotiated Rate	$444.55
Max. Negotiated Rate	$7,826.50
Rate for Payer: Aetna Commercial	$5,948.14
Rate for Payer: Aetna Medicare Advantage	$4,695.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,991.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,991.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,130.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,991.51
Rate for Payer: Cigna Commercial	$7,826.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,788.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,347.95
Rate for Payer: UnitedHealthcare Community & State	$494.63
Rate for Payer: Wellpoint Medicaid Managed Care	$444.55

POWERPORT VUE IMPL MRI 8F

Facility

$15,653.00

Service Code	HCPCS C1788
Hospital Charge Code	270698817
Hospital Revenue Code	278
Min. Negotiated Rate	$2,347.95
Max. Negotiated Rate	$3,788.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,130.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,788.03
Rate for Payer: Qualcare PPO/HMO/WC	$2,347.95

POWER PULSE KIT (Y CONNECTOR)

Facility

$170.00

Hospital Charge Code	270645569C
Hospital Revenue Code	272
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.20
Rate for Payer: Oxford Commercial	$34.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$34.00
Rate for Payer: UnitedHealthcare Community & State	$5.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4.83

POWER PULSE KIT (Y CONNECTOR)

Facility

$170.00

Hospital Charge Code	270645569A
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

POWER PULSE KIT (Y CONNECTOR)

Facility

$170.00

Hospital Charge Code	270645569A
Hospital Revenue Code	272
Min. Negotiated Rate	$4.83
Max. Negotiated Rate	$85.00
Rate for Payer: Aetna Commercial	$64.60
Rate for Payer: Aetna Medicare Advantage	$51.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.35
Rate for Payer: Cigna Commercial	$85.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.20
Rate for Payer: Oxford Commercial	$34.00
Rate for Payer: Qualcare PPO/HMO/WC	$25.50
Rate for Payer: UnitedHealthcare Commercial	$34.00
Rate for Payer: UnitedHealthcare Community & State	$5.37
Rate for Payer: Wellpoint Medicaid Managed Care	$4.83

POWER PULSE KIT (Y CONNECTOR)

Facility

$170.00

Hospital Charge Code	270645569C
Hospital Revenue Code	272
Min. Negotiated Rate	$25.50
Max. Negotiated Rate	$25.50
Rate for Payer: Qualcare PPO/HMO/WC	$25.50

POWERRASP 4.0 MM x 13 CM

Facility

$725.00

Hospital Charge Code	270682021
Hospital Revenue Code	272
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.50
Rate for Payer: Oxford Commercial	$145.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$145.00
Rate for Payer: UnitedHealthcare Community & State	$22.91
Rate for Payer: Wellpoint Medicaid Managed Care	$20.59

POWERRASP 4.0 MM x 13 CM

Facility

$725.00

Hospital Charge Code	270682021
Hospital Revenue Code	272
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

POWER RASP SMALL HUM 3.5 MM X

Facility

$725.00

Hospital Charge Code	270691592
Hospital Revenue Code	272
Min. Negotiated Rate	$108.75
Max. Negotiated Rate	$108.75
Rate for Payer: Qualcare PPO/HMO/WC	$108.75

POWER RASP SMALL HUM 3.5 MM X

Facility

$725.00

Hospital Charge Code	270691592
Hospital Revenue Code	272
Min. Negotiated Rate	$20.59
Max. Negotiated Rate	$362.50
Rate for Payer: Aetna Commercial	$275.50
Rate for Payer: Aetna Medicare Advantage	$217.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$184.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$184.88
Rate for Payer: Cigna Commercial	$362.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$188.50
Rate for Payer: Oxford Commercial	$145.00
Rate for Payer: Qualcare PPO/HMO/WC	$108.75
Rate for Payer: UnitedHealthcare Commercial	$145.00
Rate for Payer: UnitedHealthcare Community & State	$22.91
Rate for Payer: Wellpoint Medicaid Managed Care	$20.59

PPD SKIN TEST

Facility

$33.00

Service Code	HCPCS 86580
Hospital Charge Code	84206255
Hospital Revenue Code	302
Min. Negotiated Rate	$4.95
Max. Negotiated Rate	$4.95
Rate for Payer: Qualcare PPO/HMO/WC	$4.95

PPD SKIN TEST

Facility

$33.00

Service Code	HCPCS 86580
Hospital Charge Code	84206255
Hospital Revenue Code	302
Min. Negotiated Rate	$0.94
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$93.46
Rate for Payer: Aetna Medicare Advantage	$111.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$124.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$34.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$124.64
Rate for Payer: Cigna Commercial	$68.87
Rate for Payer: Cigna Medicare Advantage	$34.36
Rate for Payer: Clover Medicare Advantage	$32.64
Rate for Payer: EmblemHealth Commercial	$103.08
Rate for Payer: Humana Medicare Advantage	$35.39
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$34.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$8.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$34.36
Rate for Payer: Wellcare Medicare Advantage	$34.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.94

PRAMIPEXOLE 0.125 MG TAB

Facility

$19.77

Service Code	NDC 13668009190
Hospital Charge Code	60628688
Hospital Revenue Code	250
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$2.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.97

PRAMIPEXOLE 0.125 MG TAB

Facility

$19.77

Service Code	NDC 13668009190
Hospital Charge Code	60628688
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$9.88
Rate for Payer: Aetna Commercial	$7.51
Rate for Payer: Aetna Medicare Advantage	$5.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.04
Rate for Payer: Cigna Commercial	$9.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.14
Rate for Payer: Oxford Commercial	$3.95
Rate for Payer: Qualcare PPO/HMO/WC	$2.97
Rate for Payer: UnitedHealthcare Commercial	$3.95
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

PRAMIPEXOLE 0.25 MG TAB

Facility

$8.44

Service Code	NDC 597018461
Hospital Charge Code	60628689
Hospital Revenue Code	250
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$1.27

PRAMIPEXOLE 0.25 MG TAB

Facility

$8.44

Service Code	NDC 597018461
Hospital Charge Code	60628689
Hospital Revenue Code	250
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.22
Rate for Payer: Aetna Commercial	$3.21
Rate for Payer: Aetna Medicare Advantage	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.15
Rate for Payer: Cigna Commercial	$4.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.19
Rate for Payer: Oxford Commercial	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.27
Rate for Payer: UnitedHealthcare Commercial	$1.69
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

PRAMIPEXOLE 0.5 MG TAB

Facility

$19.77

Service Code	NDC 13668009390
Hospital Charge Code	60629058
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$9.88
Rate for Payer: Aetna Commercial	$7.51
Rate for Payer: Aetna Medicare Advantage	$5.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.04
Rate for Payer: Cigna Commercial	$9.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.14
Rate for Payer: Oxford Commercial	$3.95
Rate for Payer: Qualcare PPO/HMO/WC	$2.97
Rate for Payer: UnitedHealthcare Commercial	$3.95
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

PRAMIPEXOLE 0.5 MG TAB

Facility

$19.77

Service Code	NDC 13668009390
Hospital Charge Code	60629058
Hospital Revenue Code	250
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$2.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.97

PRAMIPEXOLE 1.5 MG TAB

Facility

$19.77

Service Code	NDC 13668009590
Hospital Charge Code	60629030
Hospital Revenue Code	250
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$2.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.97

PRAMIPEXOLE 1.5 MG TAB

Facility

$19.77

Service Code	NDC 13668009590
Hospital Charge Code	60629030
Hospital Revenue Code	250
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$9.88
Rate for Payer: Aetna Commercial	$7.51
Rate for Payer: Aetna Medicare Advantage	$5.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.04
Rate for Payer: Cigna Commercial	$9.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.14
Rate for Payer: Oxford Commercial	$3.95
Rate for Payer: Qualcare PPO/HMO/WC	$2.97
Rate for Payer: UnitedHealthcare Commercial	$3.95
Rate for Payer: UnitedHealthcare Community & State	$0.62
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

PRAMOXINE SOL 1%

Facility

$652.45

Service Code	NDC 37682315
Hospital Charge Code	60628421
Hospital Revenue Code	250
Min. Negotiated Rate	$97.87
Max. Negotiated Rate	$97.87
Rate for Payer: Qualcare PPO/HMO/WC	$97.87

PRAMOXINE SOL 1%

Facility

$652.45

Service Code	NDC 37682315
Hospital Charge Code	60628421
Hospital Revenue Code	250
Min. Negotiated Rate	$18.53
Max. Negotiated Rate	$326.23
Rate for Payer: Aetna Commercial	$247.93
Rate for Payer: Aetna Medicare Advantage	$195.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.37
Rate for Payer: Cigna Commercial	$326.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$169.64
Rate for Payer: Oxford Commercial	$130.49
Rate for Payer: Qualcare PPO/HMO/WC	$97.87
Rate for Payer: UnitedHealthcare Commercial	$130.49
Rate for Payer: UnitedHealthcare Community & State	$20.62
Rate for Payer: Wellpoint Medicaid Managed Care	$18.53

PRANDIN 1 MG

Facility

$60.43

Service Code	NDC 60846088201
Hospital Charge Code	60632257
Hospital Revenue Code	250
Min. Negotiated Rate	$9.06
Max. Negotiated Rate	$9.06
Rate for Payer: Qualcare PPO/HMO/WC	$9.06

PRANDIN 1 MG

Facility

$60.43

Service Code	NDC 60846088201
Hospital Charge Code	60632257
Hospital Revenue Code	250
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$30.21
Rate for Payer: Aetna Commercial	$22.96
Rate for Payer: Aetna Medicare Advantage	$18.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$30.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.71
Rate for Payer: Oxford Commercial	$12.09
Rate for Payer: Qualcare PPO/HMO/WC	$9.06
Rate for Payer: UnitedHealthcare Commercial	$12.09
Rate for Payer: UnitedHealthcare Community & State	$1.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

Know your out-of-pocket cost for care.

All Charges