Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES

Facility

$22,905.50

Service Code	APR-DRG 8501
Min. Negotiated Rate	$22,456.37
Max. Negotiated Rate	$22,905.50
Rate for Payer: UnitedHealthcare Community & State	$22,456.37
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$22,905.50
Rate for Payer: Wellpoint Medicaid Managed Care	$22,456.37

PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES

Facility

$30,454.01

Service Code	APR-DRG 8502
Min. Negotiated Rate	$29,856.87
Max. Negotiated Rate	$30,454.01
Rate for Payer: UnitedHealthcare Community & State	$29,856.87
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$30,454.01
Rate for Payer: Wellpoint Medicaid Managed Care	$29,856.87

PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES

Facility

$84,944.03

Service Code	APR-DRG 8504
Min. Negotiated Rate	$83,278.46
Max. Negotiated Rate	$84,944.03
Rate for Payer: UnitedHealthcare Community & State	$83,278.46
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$84,944.03
Rate for Payer: Wellpoint Medicaid Managed Care	$83,278.46

PROCEED MESH 10 X 13

Facility

$11,523.00

Hospital Charge Code	270332659
Hospital Revenue Code	278
Min. Negotiated Rate	$327.25
Max. Negotiated Rate	$5,761.50
Rate for Payer: Aetna Commercial	$4,378.74
Rate for Payer: Aetna Medicare Advantage	$3,456.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,938.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,938.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,304.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,938.36
Rate for Payer: Cigna Commercial	$5,761.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,788.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,728.45
Rate for Payer: UnitedHealthcare Community & State	$364.13
Rate for Payer: Wellpoint Medicaid Managed Care	$327.25

PROCEED MESH 10 X 13

Facility

$11,523.00

Hospital Charge Code	270332659
Hospital Revenue Code	278
Min. Negotiated Rate	$1,728.45
Max. Negotiated Rate	$2,788.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,304.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,788.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,728.45

PROCEED MESH 4X6

Facility

$2,247.00

Hospital Charge Code	270332615
Hospital Revenue Code	278
Min. Negotiated Rate	$63.81
Max. Negotiated Rate	$1,123.50
Rate for Payer: Aetna Commercial	$853.86
Rate for Payer: Aetna Medicare Advantage	$674.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$572.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$572.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$449.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$572.99
Rate for Payer: Cigna Commercial	$1,123.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$543.77
Rate for Payer: Qualcare PPO/HMO/WC	$337.05
Rate for Payer: UnitedHealthcare Community & State	$71.01
Rate for Payer: Wellpoint Medicaid Managed Care	$63.81

PROCEED MESH 4X6

Facility

$2,247.00

Hospital Charge Code	270332615
Hospital Revenue Code	278
Min. Negotiated Rate	$337.05
Max. Negotiated Rate	$543.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$449.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$543.77
Rate for Payer: Qualcare PPO/HMO/WC	$337.05

PROCEED MESH 6X8

Facility

$4,066.00

Hospital Charge Code	270332616
Hospital Revenue Code	278
Min. Negotiated Rate	$609.90
Max. Negotiated Rate	$983.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$813.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.97
Rate for Payer: Qualcare PPO/HMO/WC	$609.90

PROCEED MESH 6X8

Facility

$4,066.00

Hospital Charge Code	270332616
Hospital Revenue Code	278
Min. Negotiated Rate	$115.47
Max. Negotiated Rate	$2,033.00
Rate for Payer: Aetna Commercial	$1,545.08
Rate for Payer: Aetna Medicare Advantage	$1,219.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,036.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,036.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$813.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,036.83
Rate for Payer: Cigna Commercial	$2,033.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$983.97
Rate for Payer: Qualcare PPO/HMO/WC	$609.90
Rate for Payer: UnitedHealthcare Community & State	$128.49
Rate for Payer: Wellpoint Medicaid Managed Care	$115.47

PROCEED MESH 8X10

Facility

$11,523.00

Hospital Charge Code	270332617
Hospital Revenue Code	278
Min. Negotiated Rate	$327.25
Max. Negotiated Rate	$5,761.50
Rate for Payer: Aetna Commercial	$4,378.74
Rate for Payer: Aetna Medicare Advantage	$3,456.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,938.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,938.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,304.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,938.36
Rate for Payer: Cigna Commercial	$5,761.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,788.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,728.45
Rate for Payer: UnitedHealthcare Community & State	$364.13
Rate for Payer: Wellpoint Medicaid Managed Care	$327.25

PROCEED MESH 8X10

Facility

$11,523.00

Hospital Charge Code	270332617
Hospital Revenue Code	278
Min. Negotiated Rate	$1,728.45
Max. Negotiated Rate	$2,788.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,304.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,788.57
Rate for Payer: Qualcare PPO/HMO/WC	$1,728.45

PROCEED MESH 8 X 12

Facility

$3,425.00

Hospital Charge Code	270332660
Hospital Revenue Code	278
Min. Negotiated Rate	$97.27
Max. Negotiated Rate	$1,712.50
Rate for Payer: Aetna Commercial	$1,301.50
Rate for Payer: Aetna Medicare Advantage	$1,027.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$873.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$873.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$685.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$873.38
Rate for Payer: Cigna Commercial	$1,712.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.85
Rate for Payer: Qualcare PPO/HMO/WC	$513.75
Rate for Payer: UnitedHealthcare Community & State	$108.23
Rate for Payer: Wellpoint Medicaid Managed Care	$97.27

PROCEED MESH 8 X 12

Facility

$3,425.00

Hospital Charge Code	270332660
Hospital Revenue Code	278
Min. Negotiated Rate	$513.75
Max. Negotiated Rate	$828.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$685.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$828.85
Rate for Payer: Qualcare PPO/HMO/WC	$513.75

PROCELLERA DRESSING 1.5X 10

Facility

$187.50

Hospital Charge Code	270332707
Hospital Revenue Code	272
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$28.12
Rate for Payer: Qualcare PPO/HMO/WC	$28.12

PROCELLERA DRESSING 1.5X 10

Facility

$187.50

Hospital Charge Code	270332707
Hospital Revenue Code	272
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$93.75
Rate for Payer: Aetna Commercial	$71.25
Rate for Payer: Aetna Medicare Advantage	$56.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.81
Rate for Payer: Cigna Commercial	$93.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.12
Rate for Payer: UnitedHealthcare Commercial	$37.50
Rate for Payer: UnitedHealthcare Community & State	$5.92
Rate for Payer: Wellpoint Medicaid Managed Care	$5.33

PROCELLERA DRESSING 1.5X10

Facility

$187.50

Hospital Charge Code	270332709
Hospital Revenue Code	272
Min. Negotiated Rate	$28.12
Max. Negotiated Rate	$28.12
Rate for Payer: Qualcare PPO/HMO/WC	$28.12

PROCELLERA DRESSING 1.5X10

Facility

$187.50

Hospital Charge Code	270332709
Hospital Revenue Code	272
Min. Negotiated Rate	$5.33
Max. Negotiated Rate	$93.75
Rate for Payer: Aetna Commercial	$71.25
Rate for Payer: Aetna Medicare Advantage	$56.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.81
Rate for Payer: Cigna Commercial	$93.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.75
Rate for Payer: Oxford Commercial	$37.50
Rate for Payer: Qualcare PPO/HMO/WC	$28.12
Rate for Payer: UnitedHealthcare Commercial	$37.50
Rate for Payer: UnitedHealthcare Community & State	$5.92
Rate for Payer: Wellpoint Medicaid Managed Care	$5.33

PROCHLORPERAZINE 10MG/2 ML INJ

Facility

$72.36

Service Code	HCPCS J0780
Hospital Charge Code	60628148
Hospital Revenue Code	636
Min. Negotiated Rate	$2.06
Max. Negotiated Rate	$36.18
Rate for Payer: Aetna Commercial	$27.50
Rate for Payer: Aetna Medicare Advantage	$21.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.45
Rate for Payer: Cigna Commercial	$36.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.51
Rate for Payer: Qualcare PPO/HMO/WC	$10.85
Rate for Payer: UnitedHealthcare Community & State	$2.29
Rate for Payer: Wellpoint Medicaid Managed Care	$2.06

PROCHLORPERAZINE 10MG/2 ML INJ

Facility

$72.36

Service Code	HCPCS J0780
Hospital Charge Code	60628148
Hospital Revenue Code	636
Min. Negotiated Rate	$10.85
Max. Negotiated Rate	$17.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.51
Rate for Payer: Qualcare PPO/HMO/WC	$10.85

PROCHLORPERAZINE 10 MG UD

Facility

$6.50

Service Code	NDC 51079054220
Hospital Charge Code	60632734
Hospital Revenue Code	250
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.25
Rate for Payer: Aetna Commercial	$2.47
Rate for Payer: Aetna Medicare Advantage	$1.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.66
Rate for Payer: Cigna Commercial	$3.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.69
Rate for Payer: Oxford Commercial	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.98
Rate for Payer: UnitedHealthcare Commercial	$1.30
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

PROCHLORPERAZINE 10 MG UD

Facility

$6.50

Service Code	NDC 51079054220
Hospital Charge Code	60632734
Hospital Revenue Code	250
Min. Negotiated Rate	$0.98
Max. Negotiated Rate	$0.98
Rate for Payer: Qualcare PPO/HMO/WC	$0.98

PROCHLORPERAZINE 25 MG SUPP

Facility

$82.14

Service Code	HCPCS Q0164
Hospital Charge Code	60628147
Hospital Revenue Code	636
Min. Negotiated Rate	$12.32
Max. Negotiated Rate	$19.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.88
Rate for Payer: Qualcare PPO/HMO/WC	$12.32

PROCHLORPERAZINE 25 MG SUPP

Facility

$82.14

Service Code	HCPCS Q0164
Hospital Charge Code	60628147
Hospital Revenue Code	636
Min. Negotiated Rate	$2.33
Max. Negotiated Rate	$41.07
Rate for Payer: Aetna Commercial	$31.21
Rate for Payer: Aetna Medicare Advantage	$24.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.95
Rate for Payer: Cigna Commercial	$41.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.88
Rate for Payer: Qualcare PPO/HMO/WC	$12.32
Rate for Payer: UnitedHealthcare Community & State	$2.60
Rate for Payer: Wellpoint Medicaid Managed Care	$2.33

PROCHLORPERAZINE 5 MG TAB

Facility

$4.09

Service Code	HCPCS J8597
Hospital Charge Code	60629225
Hospital Revenue Code	636
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.04
Rate for Payer: Aetna Commercial	$1.55
Rate for Payer: Aetna Medicare Advantage	$1.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.04
Rate for Payer: Cigna Commercial	$2.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.99
Rate for Payer: Qualcare PPO/HMO/WC	$0.61
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

PROCHLORPERAZINE 5 MG TAB

Facility

$4.09

Service Code	HCPCS J8597
Hospital Charge Code	60629225
Hospital Revenue Code	636
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$0.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.99
Rate for Payer: Qualcare PPO/HMO/WC	$0.61

Know your out-of-pocket cost for care.

All Charges