Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PREDNISOLONE ACETATE 1% EYE

Facility

$370.64

Service Code	NDC 61314063705
Hospital Charge Code	60628041
Hospital Revenue Code	250
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$185.32
Rate for Payer: Aetna Commercial	$140.84
Rate for Payer: Aetna Medicare Advantage	$111.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.51
Rate for Payer: Cigna Commercial	$185.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.37
Rate for Payer: Oxford Commercial	$74.13
Rate for Payer: Qualcare PPO/HMO/WC	$55.60
Rate for Payer: UnitedHealthcare Commercial	$74.13
Rate for Payer: UnitedHealthcare Community & State	$11.71
Rate for Payer: Wellpoint Medicaid Managed Care	$10.53

PREDNISOLONE ACETATE 1% EYE

Facility

$370.64

Service Code	NDC 61314063705
Hospital Charge Code	60628041
Hospital Revenue Code	250
Min. Negotiated Rate	$55.60
Max. Negotiated Rate	$55.60
Rate for Payer: Qualcare PPO/HMO/WC	$55.60

PREDNISOLONE ACETATE 1% OPHTH

Facility

$370.64

Service Code	NDC 61314063705
Hospital Charge Code	6063943239
Hospital Revenue Code	250
Min. Negotiated Rate	$10.53
Max. Negotiated Rate	$185.32
Rate for Payer: Aetna Commercial	$140.84
Rate for Payer: Aetna Medicare Advantage	$111.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$94.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$94.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$94.51
Rate for Payer: Cigna Commercial	$185.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$96.37
Rate for Payer: Oxford Commercial	$74.13
Rate for Payer: Qualcare PPO/HMO/WC	$55.60
Rate for Payer: UnitedHealthcare Commercial	$74.13
Rate for Payer: UnitedHealthcare Community & State	$11.71
Rate for Payer: Wellpoint Medicaid Managed Care	$10.53

PREDNISOLONE ACETATE 1% OPHTH

Facility

$370.64

Service Code	NDC 61314063705
Hospital Charge Code	6063943239
Hospital Revenue Code	250
Min. Negotiated Rate	$55.60
Max. Negotiated Rate	$55.60
Rate for Payer: Qualcare PPO/HMO/WC	$55.60

PREDNISONE 10 MG TAB

Facility

$4.00

Service Code	NDC 143147301
Hospital Charge Code	60629306
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PREDNISONE 10 MG TAB

Facility

$4.00

Service Code	NDC 143147301
Hospital Charge Code	60629306
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

PREDNISONE 1 MG TAB

Facility

$4.00

Service Code	NDC 54873925
Hospital Charge Code	60628208
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PREDNISONE 1 MG TAB

Facility

$4.00

Service Code	NDC 54873925
Hospital Charge Code	60628208
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

PREDNISONE 20 MG TAB

Facility

$4.00

Service Code	NDC 54001825
Hospital Charge Code	6024269
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

PREDNISONE 20 MG TAB

Facility

$4.00

Service Code	NDC 54001825
Hospital Charge Code	6024269
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PREDNISONE/2.5MG/TAB

Facility

$4.00

Service Code	NDC 54874025
Hospital Charge Code	60633700
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PREDNISONE/2.5MG/TAB

Facility

$4.00

Service Code	NDC 54874025
Hospital Charge Code	60633700
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

PREDNISONE 5 MG TAB

Facility

$4.00

Service Code	NDC 54872425
Hospital Charge Code	6022792
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

PREDNISONE 5 MG TAB

Facility

$4.00

Service Code	NDC 54872425
Hospital Charge Code	6022792
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PREDNISONE ELX 5MG/5ML

Facility

$9.05

Service Code	NDC 54872216
Hospital Charge Code	60628209
Hospital Revenue Code	250
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$1.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.36

PREDNISONE ELX 5MG/5ML

Facility

$9.05

Service Code	NDC 54872216
Hospital Charge Code	60628209
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$4.53
Rate for Payer: Aetna Commercial	$3.44
Rate for Payer: Aetna Medicare Advantage	$2.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.31
Rate for Payer: Cigna Commercial	$4.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.35
Rate for Payer: Oxford Commercial	$1.81
Rate for Payer: Qualcare PPO/HMO/WC	$1.36
Rate for Payer: UnitedHealthcare Commercial	$1.81
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

PREDNSOLN 15MG/5ML ORAL 240 ML

Facility

$10.45

Service Code	HCPCS J7510
Hospital Charge Code	60629124
Hospital Revenue Code	636
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$2.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

PREDNSOLN 15MG/5ML ORAL 240 ML

Facility

$10.45

Service Code	HCPCS J7510
Hospital Charge Code	60629124
Hospital Revenue Code	636
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$5.22
Rate for Payer: Aetna Commercial	$3.97
Rate for Payer: Aetna Medicare Advantage	$3.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.66
Rate for Payer: Cigna Commercial	$5.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.53
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

PREFAB PORC CERAMCROWN PRI

Facility

$9,790.05

Service Code	HCPCS D2929
Hospital Charge Code	1600000778
Hospital Revenue Code	360
Min. Negotiated Rate	$278.04
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,089.07
Rate for Payer: Aetna Medicare Advantage	$2,488.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,786.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,786.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$768.04
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	$2,786.07
Rate for Payer: Cigna Commercial	$1,539.55
Rate for Payer: Cigna Medicare Advantage	$768.04
Rate for Payer: Clover Medicare Advantage	$729.64
Rate for Payer: EmblemHealth Commercial	$2,304.12
Rate for Payer: Humana Medicare Advantage	$791.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$768.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,545.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.51
Rate for Payer: UnitedHealthcare Community & State	$309.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$768.04
Rate for Payer: Wellcare Medicare Advantage	$768.04
Rate for Payer: Wellpoint Medicaid Managed Care	$278.04

PREFAB PORC CERAMCROWN PRI

Facility

$9,790.05

Service Code	HCPCS D2929
Hospital Charge Code	1600000778
Hospital Revenue Code	360
Min. Negotiated Rate	$1,468.51
Max. Negotiated Rate	$1,468.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.51

PREFABSTNLSS STEEL CROWN PRI

Facility

$9,790.05

Service Code	HCPCS D2930
Hospital Charge Code	1600000742
Hospital Revenue Code	360
Min. Negotiated Rate	$1,468.51
Max. Negotiated Rate	$1,468.51
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.51

PREFABSTNLSS STEEL CROWN PRI

Facility

$9,790.05

Service Code	HCPCS D2930
Hospital Charge Code	1600000742
Hospital Revenue Code	360
Min. Negotiated Rate	$278.04
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$2,089.07
Rate for Payer: Aetna Medicare Advantage	$2,488.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,786.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,786.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$768.04
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	$2,786.07
Rate for Payer: Cigna Commercial	$1,539.55
Rate for Payer: Cigna Medicare Advantage	$768.04
Rate for Payer: Clover Medicare Advantage	$729.64
Rate for Payer: EmblemHealth Commercial	$2,304.12
Rate for Payer: Humana Medicare Advantage	$791.08
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$768.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,545.41
Rate for Payer: Qualcare PPO/HMO/WC	$1,468.51
Rate for Payer: UnitedHealthcare Community & State	$309.37
Rate for Payer: UnitedHealthcare Medicare Advantage	$768.04
Rate for Payer: Wellcare Medicare Advantage	$768.04
Rate for Payer: Wellpoint Medicaid Managed Care	$278.04

PREFILER SMOKE EVACUATOR

Facility

$32.60

Hospital Charge Code	270657864
Hospital Revenue Code	270
Min. Negotiated Rate	$4.89
Max. Negotiated Rate	$4.89
Rate for Payer: Qualcare PPO/HMO/WC	$4.89

PREFILER SMOKE EVACUATOR

Facility

$32.60

Hospital Charge Code	270657864
Hospital Revenue Code	270
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$16.30
Rate for Payer: Aetna Commercial	$12.39
Rate for Payer: Aetna Medicare Advantage	$9.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.31
Rate for Payer: Cigna Commercial	$16.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.48
Rate for Payer: Oxford Commercial	$6.52
Rate for Payer: Qualcare PPO/HMO/WC	$4.89
Rate for Payer: UnitedHealthcare Commercial	$6.52
Rate for Payer: UnitedHealthcare Community & State	$1.03
Rate for Payer: Wellpoint Medicaid Managed Care	$0.93

PREGABALIN

Facility

$72.40

Service Code	HCPCS 80299
Hospital Charge Code	39708027
Hospital Revenue Code	301
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$50.70
Rate for Payer: Aetna Medicare Advantage	$60.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$67.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$67.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$9.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$67.62
Rate for Payer: Cigna Commercial	$36.20
Rate for Payer: Cigna Medicare Advantage	$18.64
Rate for Payer: Clover Medicare Advantage	$17.71
Rate for Payer: EmblemHealth Commercial	$55.92
Rate for Payer: Humana Medicare Advantage	$19.20
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.82
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$10.86
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.91
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.64
Rate for Payer: Wellcare Medicare Advantage	$18.64
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

Know your out-of-pocket cost for care.

All Charges