Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PROPRANOLOL 20 MG TAB

Facility

$4.00

Service Code	NDC 50111046801
Hospital Charge Code	60627600
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

PROPRANOLOL 40 MG TAB

Facility

$4.82

Service Code	NDC 23155011201
Hospital Charge Code	60627601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$0.72
Rate for Payer: Qualcare PPO/HMO/WC	$0.72

PROPRANOLOL 40 MG TAB

Facility

$4.82

Service Code	NDC 23155011201
Hospital Charge Code	60627601
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.41
Rate for Payer: Aetna Commercial	$1.83
Rate for Payer: Aetna Medicare Advantage	$1.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.23
Rate for Payer: Cigna Commercial	$2.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.25
Rate for Payer: Oxford Commercial	$0.96
Rate for Payer: Qualcare PPO/HMO/WC	$0.72
Rate for Payer: UnitedHealthcare Commercial	$0.96
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

PROPRANOLOL 60 MG ER CAP

Facility

$14.61

Service Code	NDC 68084050301
Hospital Charge Code	60627602
Hospital Revenue Code	250
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$7.30
Rate for Payer: Aetna Commercial	$5.55
Rate for Payer: Aetna Medicare Advantage	$4.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.73
Rate for Payer: Cigna Commercial	$7.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.80
Rate for Payer: Oxford Commercial	$2.92
Rate for Payer: Qualcare PPO/HMO/WC	$2.19
Rate for Payer: UnitedHealthcare Commercial	$2.92
Rate for Payer: UnitedHealthcare Community & State	$0.46
Rate for Payer: Wellpoint Medicaid Managed Care	$0.41

PROPRANOLOL 60 MG ER CAP

Facility

$14.61

Service Code	NDC 68084050301
Hospital Charge Code	60627602
Hospital Revenue Code	250
Min. Negotiated Rate	$2.19
Max. Negotiated Rate	$2.19
Rate for Payer: Qualcare PPO/HMO/WC	$2.19

PROPRANOLOL 80 MG ER CAP

Facility

$168.84

Service Code	NDC 24090047188
Hospital Charge Code	60627603
Hospital Revenue Code	250
Min. Negotiated Rate	$4.80
Max. Negotiated Rate	$84.42
Rate for Payer: Aetna Commercial	$64.16
Rate for Payer: Aetna Medicare Advantage	$50.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.05
Rate for Payer: Cigna Commercial	$84.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$43.90
Rate for Payer: Oxford Commercial	$33.77
Rate for Payer: Qualcare PPO/HMO/WC	$25.33
Rate for Payer: UnitedHealthcare Commercial	$33.77
Rate for Payer: UnitedHealthcare Community & State	$5.34
Rate for Payer: Wellpoint Medicaid Managed Care	$4.80

PROPRANOLOL 80 MG ER CAP

Facility

$168.84

Service Code	NDC 24090047188
Hospital Charge Code	60627603
Hospital Revenue Code	250
Min. Negotiated Rate	$25.33
Max. Negotiated Rate	$25.33
Rate for Payer: Qualcare PPO/HMO/WC	$25.33

PROPRANOLOL (INDERAL)

Facility

$324.00

Service Code	HCPCS 80299
Hospital Charge Code	38472569
Hospital Revenue Code	301
Min. Negotiated Rate	$9.20
Max. Negotiated Rate	$162.00
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	$162.00
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	$84.24
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$48.60
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	$9.20

PROPRANOLOL (INDERAL)

Facility

$324.00

Service Code	HCPCS 80299
Hospital Charge Code	38472569
Hospital Revenue Code	301
Min. Negotiated Rate	$48.60
Max. Negotiated Rate	$48.60
Rate for Payer: Qualcare PPO/HMO/WC	$48.60

PRO-PREDICTRX METABOLITES

Facility

$124.10

Service Code	HCPCS 82542
Hospital Charge Code	39900060
Hospital Revenue Code	301
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$65.52
Rate for Payer: Aetna Medicare Advantage	$78.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.39
Rate for Payer: Cigna Commercial	$62.05
Rate for Payer: Cigna Medicare Advantage	$24.09
Rate for Payer: Clover Medicare Advantage	$22.89
Rate for Payer: EmblemHealth Commercial	$72.27
Rate for Payer: Humana Medicare Advantage	$24.81
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.27
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.61
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.27
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.09
Rate for Payer: Wellcare Medicare Advantage	$24.09
Rate for Payer: Wellpoint Medicaid Managed Care	$3.52

PRO-PREDICTRX METABOLITES

Facility

$124.10

Service Code	HCPCS 82542
Hospital Charge Code	39900060
Hospital Revenue Code	301
Min. Negotiated Rate	$18.61
Max. Negotiated Rate	$18.61
Rate for Payer: Qualcare PPO/HMO/WC	$18.61

PROPYLTHIOURACIL 50 MG TAB

Facility

$6.03

Service Code	NDC 480924201
Hospital Charge Code	60628266
Hospital Revenue Code	250
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$0.90
Rate for Payer: Qualcare PPO/HMO/WC	$0.90

PROPYLTHIOURACIL 50 MG TAB

Facility

$6.03

Service Code	NDC 480924201
Hospital Charge Code	60628266
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.02
Rate for Payer: Aetna Commercial	$2.29
Rate for Payer: Aetna Medicare Advantage	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.54
Rate for Payer: Cigna Commercial	$3.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.57
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.90
Rate for Payer: UnitedHealthcare Commercial	$1.21
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

PROQUAD 0.5ML VIAL

Facility

$1,217.46

Service Code	HCPCS 90710
Hospital Charge Code	83652587
Hospital Revenue Code	636
Min. Negotiated Rate	$182.62
Max. Negotiated Rate	$294.63
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.63
Rate for Payer: Qualcare PPO/HMO/WC	$182.62

PROQUAD 0.5ML VIAL

Facility

$1,217.46

Service Code	HCPCS 90710
Hospital Charge Code	83652587
Hospital Revenue Code	636
Min. Negotiated Rate	$14.30
Max. Negotiated Rate	$608.73
Rate for Payer: Aetna Commercial	$462.63
Rate for Payer: Aetna Medicare Advantage	$365.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$310.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$310.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$310.45
Rate for Payer: Cigna Commercial	$608.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$294.63
Rate for Payer: Qualcare PPO/HMO/WC	$182.62
Rate for Payer: UnitedHealthcare Community & State	$38.47
Rate for Payer: Wellpoint Medicaid Managed Care	$34.58

PROSHIELD PLUS SPRAY

Facility

$49.85

Service Code	NDC 64015008
Hospital Charge Code	6063943165
Hospital Revenue Code	250
Min. Negotiated Rate	$7.48
Max. Negotiated Rate	$7.48
Rate for Payer: Qualcare PPO/HMO/WC	$7.48

PROSHIELD PLUS SPRAY

Facility

$49.85

Service Code	NDC 64015008
Hospital Charge Code	6063943165
Hospital Revenue Code	250
Min. Negotiated Rate	$1.42
Max. Negotiated Rate	$24.93
Rate for Payer: Aetna Commercial	$18.94
Rate for Payer: Aetna Medicare Advantage	$14.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.71
Rate for Payer: Cigna Commercial	$24.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.96
Rate for Payer: Oxford Commercial	$9.97
Rate for Payer: Qualcare PPO/HMO/WC	$7.48
Rate for Payer: UnitedHealthcare Commercial	$9.97
Rate for Payer: UnitedHealthcare Community & State	$1.58
Rate for Payer: Wellpoint Medicaid Managed Care	$1.42

PROSTAGLANDIN,EACH

Facility

$176.00

Service Code	HCPCS 84150
Hospital Charge Code	38477177
Hospital Revenue Code	301
Min. Negotiated Rate	$5.00
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$113.61
Rate for Payer: Aetna Medicare Advantage	$135.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$151.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$151.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$41.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$54.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$151.52
Rate for Payer: Cigna Commercial	$88.00
Rate for Payer: Cigna Medicare Advantage	$41.77
Rate for Payer: Clover Medicare Advantage	$39.68
Rate for Payer: EmblemHealth Commercial	$125.31
Rate for Payer: Humana Medicare Advantage	$43.02
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$41.77
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.76
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.40
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$33.42
Rate for Payer: UnitedHealthcare Medicare Advantage	$41.77
Rate for Payer: Wellcare Medicare Advantage	$41.77
Rate for Payer: Wellpoint Medicaid Managed Care	$5.00

PROSTAGLANDIN,EACH

Facility

$176.00

Service Code	HCPCS 84150
Hospital Charge Code	38477177
Hospital Revenue Code	301
Min. Negotiated Rate	$26.40
Max. Negotiated Rate	$26.40
Rate for Payer: Qualcare PPO/HMO/WC	$26.40

PROSTATECTOMY WITH CC

Facility

$74,731.24

Service Code	MSDRG 666
Min. Negotiated Rate	$22,754.70
Max. Negotiated Rate	$74,731.24
Rate for Payer: Aetna Commercial	$55,082.94
Rate for Payer: Aetna Medicare Advantage	$74,731.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47,652.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47,652.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$23,952.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47,652.60
Rate for Payer: Cigna Commercial	$38,997.14
Rate for Payer: Cigna Medicare Advantage	$23,952.32
Rate for Payer: Clover Medicare Advantage	$22,754.70
Rate for Payer: EmblemHealth Commercial	$71,856.96
Rate for Payer: Humana Medicare Advantage	$24,670.89
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$23,952.32
Rate for Payer: Oxford Commercial	$30,822.67
Rate for Payer: UnitedHealthcare Commercial	$41,257.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$23,952.32
Rate for Payer: Wellcare Medicare Advantage	$23,952.32

PROSTATECTOMY WITH MCC

Facility

$118,074.47

Service Code	MSDRG 665
Min. Negotiated Rate	$35,952.16
Max. Negotiated Rate	$118,074.47
Rate for Payer: Aetna Commercial	$85,952.49
Rate for Payer: Aetna Medicare Advantage	$118,074.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85,608.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85,608.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$37,844.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85,608.45
Rate for Payer: Cigna Commercial	$69,580.91
Rate for Payer: Cigna Medicare Advantage	$37,844.38
Rate for Payer: Clover Medicare Advantage	$35,952.16
Rate for Payer: EmblemHealth Commercial	$113,533.14
Rate for Payer: Humana Medicare Advantage	$38,979.71
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$37,844.38
Rate for Payer: Oxford Commercial	$54,995.54
Rate for Payer: UnitedHealthcare Commercial	$73,613.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$37,844.38
Rate for Payer: Wellcare Medicare Advantage	$37,844.38

PROSTATECTOMY WITHOUT CC/MCC

Facility

$54,413.46

Service Code	MSDRG 667
Min. Negotiated Rate	$16,568.20
Max. Negotiated Rate	$54,413.46
Rate for Payer: Aetna Commercial	$40,612.40
Rate for Payer: Aetna Medicare Advantage	$54,413.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29,090.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29,090.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$17,440.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29,090.25
Rate for Payer: Cigna Commercial	$24,660.52
Rate for Payer: Cigna Medicare Advantage	$17,440.21
Rate for Payer: Clover Medicare Advantage	$16,568.20
Rate for Payer: EmblemHealth Commercial	$52,320.63
Rate for Payer: Humana Medicare Advantage	$17,963.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$17,440.21
Rate for Payer: Oxford Commercial	$19,491.24
Rate for Payer: UnitedHealthcare Commercial	$26,089.73
Rate for Payer: UnitedHealthcare Medicare Advantage	$17,440.21
Rate for Payer: Wellcare Medicare Advantage	$17,440.21

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55709
Hospital Charge Code	404155709
Hospital Revenue Code	361
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55712
Hospital Charge Code	1600000845
Hospital Revenue Code	360
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

PROSTATE NEEDLE PUNCH BX

Facility

$5,698.20

Service Code	HCPCS 55705
Hospital Charge Code	160000213
Hospital Revenue Code	360
Min. Negotiated Rate	$854.73
Max. Negotiated Rate	$854.73
Rate for Payer: Qualcare PPO/HMO/WC	$854.73

Know your out-of-pocket cost for care.

All Charges