Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PRASUGREL 10MG TAB

Facility

$86.63

Service Code	NDC 2512377
Hospital Charge Code	60630033
Hospital Revenue Code	250
Min. Negotiated Rate	$12.99
Max. Negotiated Rate	$12.99
Rate for Payer: Qualcare PPO/HMO/WC	$12.99

PRASUGREL 10MG TAB

Facility

$86.63

Service Code	NDC 2512377
Hospital Charge Code	60630033
Hospital Revenue Code	250
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$43.31
Rate for Payer: Aetna Commercial	$32.92
Rate for Payer: Aetna Medicare Advantage	$25.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.09
Rate for Payer: Cigna Commercial	$43.31
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.52
Rate for Payer: Oxford Commercial	$17.33
Rate for Payer: Qualcare PPO/HMO/WC	$12.99
Rate for Payer: UnitedHealthcare Commercial	$17.33
Rate for Payer: UnitedHealthcare Community & State	$2.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2.46

PRAVASTATIN SODIUM 10 MG TAB

Facility

$19.36

Service Code	NDC 904589161
Hospital Charge Code	6063943235
Hospital Revenue Code	250
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$9.68
Rate for Payer: Aetna Commercial	$7.36
Rate for Payer: Aetna Medicare Advantage	$5.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.94
Rate for Payer: Cigna Commercial	$9.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.03
Rate for Payer: Oxford Commercial	$3.87
Rate for Payer: Qualcare PPO/HMO/WC	$2.90
Rate for Payer: UnitedHealthcare Commercial	$3.87
Rate for Payer: UnitedHealthcare Community & State	$0.61
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

PRAVASTATIN SODIUM 10 MG TAB

Facility

$19.36

Service Code	NDC 904589161
Hospital Charge Code	6063943235
Hospital Revenue Code	250
Min. Negotiated Rate	$2.90
Max. Negotiated Rate	$2.90
Rate for Payer: Qualcare PPO/HMO/WC	$2.90

PRAVASTATIN SODIUM 20 MG TAB

Facility

$4.00

Service Code	NDC 43063044330
Hospital Charge Code	6063943236
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

PRAVASTATIN SODIUM 20 MG TAB

Facility

$4.00

Service Code	NDC 43063044330
Hospital Charge Code	6063943236
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PRAVASTATIN SODIUM 40 MG TAB

Facility

$45.49

Service Code	NDC 3519410
Hospital Charge Code	6063943237
Hospital Revenue Code	250
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$22.75
Rate for Payer: Aetna Commercial	$17.29
Rate for Payer: Aetna Medicare Advantage	$13.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.60
Rate for Payer: Cigna Commercial	$22.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.83
Rate for Payer: Oxford Commercial	$9.10
Rate for Payer: Qualcare PPO/HMO/WC	$6.82
Rate for Payer: UnitedHealthcare Commercial	$9.10
Rate for Payer: UnitedHealthcare Community & State	$1.44
Rate for Payer: Wellpoint Medicaid Managed Care	$1.29

PRAVASTATIN SODIUM 40 MG TAB

Facility

$45.49

Service Code	NDC 3519410
Hospital Charge Code	6063943237
Hospital Revenue Code	250
Min. Negotiated Rate	$6.82
Max. Negotiated Rate	$6.82
Rate for Payer: Qualcare PPO/HMO/WC	$6.82

PRAZOSIN 2 MG

Facility

$16.88

Service Code	NDC 51079063120
Hospital Charge Code	606390180
Hospital Revenue Code	250
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$8.44
Rate for Payer: Aetna Commercial	$6.41
Rate for Payer: Aetna Medicare Advantage	$5.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.30
Rate for Payer: Cigna Commercial	$8.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.39
Rate for Payer: Oxford Commercial	$3.38
Rate for Payer: Qualcare PPO/HMO/WC	$2.53
Rate for Payer: UnitedHealthcare Commercial	$3.38
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

PRAZOSIN 2 MG

Facility

$16.88

Service Code	NDC 51079063120
Hospital Charge Code	606390180
Hospital Revenue Code	250
Min. Negotiated Rate	$2.53
Max. Negotiated Rate	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$2.53

PRAZOSIN 5 MG/MINIPRESS

Facility

$12.19

Service Code	NDC 51079063201
Hospital Charge Code	606390133
Hospital Revenue Code	250
Min. Negotiated Rate	$0.35
Max. Negotiated Rate	$6.09
Rate for Payer: Aetna Commercial	$4.63
Rate for Payer: Aetna Medicare Advantage	$3.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.11
Rate for Payer: Cigna Commercial	$6.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.17
Rate for Payer: Oxford Commercial	$2.44
Rate for Payer: Qualcare PPO/HMO/WC	$1.83
Rate for Payer: UnitedHealthcare Commercial	$2.44
Rate for Payer: UnitedHealthcare Community & State	$0.39
Rate for Payer: Wellpoint Medicaid Managed Care	$0.35

PRAZOSIN 5 MG/MINIPRESS

Facility

$12.19

Service Code	NDC 51079063201
Hospital Charge Code	606390133
Hospital Revenue Code	250
Min. Negotiated Rate	$1.83
Max. Negotiated Rate	$1.83
Rate for Payer: Qualcare PPO/HMO/WC	$1.83

PRAZOSIN HYDROCHLORIDE 1 MG CA

Facility

$5.03

Service Code	NDC 51079063001
Hospital Charge Code	6063943238
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.52
Rate for Payer: Aetna Commercial	$1.91
Rate for Payer: Aetna Medicare Advantage	$1.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.28
Rate for Payer: Cigna Commercial	$2.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.31
Rate for Payer: Oxford Commercial	$1.01
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.01
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

PRAZOSIN HYDROCHLORIDE 1 MG CA

Facility

$5.03

Service Code	NDC 51079063001
Hospital Charge Code	6063943238
Hospital Revenue Code	250
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

Pre-albumin

Facility

$390.00

Service Code	HCPCS 84134
Hospital Charge Code	39888031
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$39.68
Rate for Payer: Aetna Medicare Advantage	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.93
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$14.59
Rate for Payer: Clover Medicare Advantage	$13.86
Rate for Payer: EmblemHealth Commercial	$43.77
Rate for Payer: Humana Medicare Advantage	$15.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.59
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	$11.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.59
Rate for Payer: Wellcare Medicare Advantage	$14.59
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

Pre-albumin

Facility

$390.00

Service Code	HCPCS 84134
Hospital Charge Code	39888031
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

PREALBUMIN

Facility

$100.25

Service Code	HCPCS 84134
Hospital Charge Code	39900428
Hospital Revenue Code	301
Min. Negotiated Rate	$15.04
Max. Negotiated Rate	$15.04
Rate for Payer: Qualcare PPO/HMO/WC	$15.04

PREALBUMIN

Facility

$100.25

Service Code	HCPCS 84134
Hospital Charge Code	39900428
Hospital Revenue Code	301
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$39.68
Rate for Payer: Aetna Medicare Advantage	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.93
Rate for Payer: Cigna Commercial	$50.12
Rate for Payer: Cigna Medicare Advantage	$14.59
Rate for Payer: Clover Medicare Advantage	$13.86
Rate for Payer: EmblemHealth Commercial	$43.77
Rate for Payer: Humana Medicare Advantage	$15.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.07
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.04
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$11.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.59
Rate for Payer: Wellcare Medicare Advantage	$14.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.85

PREALBUMIN SERUM

Facility

$103.00

Service Code	HCPCS 84134
Hospital Charge Code	38478093
Hospital Revenue Code	301
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$15.45
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

PREALBUMIN SERUM

Facility

$103.00

Service Code	HCPCS 84134
Hospital Charge Code	38478093
Hospital Revenue Code	301
Min. Negotiated Rate	$2.93
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$39.68
Rate for Payer: Aetna Medicare Advantage	$47.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$52.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$52.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$14.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$33.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$52.93
Rate for Payer: Cigna Commercial	$51.50
Rate for Payer: Cigna Medicare Advantage	$14.59
Rate for Payer: Clover Medicare Advantage	$13.86
Rate for Payer: EmblemHealth Commercial	$43.77
Rate for Payer: Humana Medicare Advantage	$15.03
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$14.59
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	$11.67
Rate for Payer: UnitedHealthcare Medicare Advantage	$14.59
Rate for Payer: Wellcare Medicare Advantage	$14.59
Rate for Payer: Wellpoint Medicaid Managed Care	$2.93

PRE-BENT ROD 5.5X60MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270702847
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

PRE-BENT ROD 5.5X60MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270702847
Hospital Revenue Code	278
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

PRE-BENT ROD 5.5X70MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270703104
Hospital Revenue Code	278
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

PRE-BENT ROD 5.5X70MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270703104
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

PRECEPT SCREW 6.5x40MM POLYAXI

Facility

$10,285.00

Hospital Charge Code	270665929
Hospital Revenue Code	278
Min. Negotiated Rate	$292.09
Max. Negotiated Rate	$5,142.50
Rate for Payer: Aetna Commercial	$3,908.30
Rate for Payer: Aetna Medicare Advantage	$3,085.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,622.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,057.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,622.68
Rate for Payer: Cigna Commercial	$5,142.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,488.97
Rate for Payer: Qualcare PPO/HMO/WC	$1,542.75
Rate for Payer: UnitedHealthcare Community & State	$325.01
Rate for Payer: Wellpoint Medicaid Managed Care	$292.09

Know your out-of-pocket cost for care.

All Charges