Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

PURACOL+COL 4.25x4.5 MSC8644EP

Facility

$199.03

Hospital Charge Code	270640869
Hospital Revenue Code	272
Min. Negotiated Rate	$5.65
Max. Negotiated Rate	$99.52
Rate for Payer: Aetna Commercial	$75.63
Rate for Payer: Aetna Medicare Advantage	$59.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.75
Rate for Payer: Cigna Commercial	$99.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.75
Rate for Payer: Oxford Commercial	$39.81
Rate for Payer: Qualcare PPO/HMO/WC	$29.85
Rate for Payer: UnitedHealthcare Commercial	$39.81
Rate for Payer: UnitedHealthcare Community & State	$6.29
Rate for Payer: Wellpoint Medicaid Managed Care	$5.65

PURACOL+COL 4.25x4.5 MSC8644EP

Facility

$199.03

Hospital Charge Code	270640869
Hospital Revenue Code	272
Min. Negotiated Rate	$29.85
Max. Negotiated Rate	$29.85
Rate for Payer: Qualcare PPO/HMO/WC	$29.85

PURACOL + COLG 2x2 5 MSC8622EP

Facility

$32.35

Hospital Charge Code	270640868
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$16.18
Rate for Payer: Aetna Commercial	$12.29
Rate for Payer: Aetna Medicare Advantage	$9.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.25
Rate for Payer: Cigna Commercial	$16.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.41
Rate for Payer: Oxford Commercial	$6.47
Rate for Payer: Qualcare PPO/HMO/WC	$4.85
Rate for Payer: UnitedHealthcare Commercial	$6.47
Rate for Payer: UnitedHealthcare Community & State	$1.02
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

PURACOL + COLG 2x2 5 MSC8622EP

Facility

$32.35

Hospital Charge Code	270640868
Hospital Revenue Code	272
Min. Negotiated Rate	$4.85
Max. Negotiated Rate	$4.85
Rate for Payer: Qualcare PPO/HMO/WC	$4.85

PURAPLY AM 6X9 CM

Facility

$13,500.00

Service Code	HCPCS Q4195
Hospital Charge Code	270676741
Hospital Revenue Code	278
Min. Negotiated Rate	$2,025.00
Max. Negotiated Rate	$3,267.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00

PURAPLY AM 6X9 CM

Facility

$13,500.00

Service Code	HCPCS Q4195
Hospital Charge Code	270676741
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$3,267.00
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,267.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,025.00
Rate for Payer: UnitedHealthcare Community & State	$426.60
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$383.40

PURAPLY AM 6X9 CM/PER SQCM JW

Facility

$560.00

Hospital Charge Code	270676741W
Hospital Revenue Code	636
Min. Negotiated Rate	$84.00
Max. Negotiated Rate	$135.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00

PURAPLY AM 6X9 CM/PER SQCM JW

Facility

$560.00

Hospital Charge Code	270676741W
Hospital Revenue Code	636
Min. Negotiated Rate	$15.90
Max. Negotiated Rate	$280.00
Rate for Payer: Aetna Commercial	$212.80
Rate for Payer: Aetna Medicare Advantage	$168.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$142.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$142.80
Rate for Payer: Cigna Commercial	$280.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.52
Rate for Payer: Qualcare PPO/HMO/WC	$84.00
Rate for Payer: UnitedHealthcare Community & State	$17.70
Rate for Payer: Wellpoint Medicaid Managed Care	$15.90

PURAPLY AM 8X16CM(FULL SHEET)

Facility

$64,000.00

Service Code	HCPCS Q4196
Hospital Charge Code	270689671
Hospital Revenue Code	636
Min. Negotiated Rate	$9,600.00
Max. Negotiated Rate	$15,488.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,488.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,600.00

PURAPLY AM 8X16CM(FULL SHEET)

Facility

$64,000.00

Service Code	HCPCS Q4196
Hospital Charge Code	270689671
Hospital Revenue Code	636
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$15,488.00
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15,488.00
Rate for Payer: Qualcare PPO/HMO/WC	$9,600.00
Rate for Payer: UnitedHealthcare Community & State	$2,022.40
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$1,817.60

PURAPLY AM PER SQ CM

Facility

$651.25

Service Code	HCPCS Q4172
Hospital Charge Code	270676737P
Hospital Revenue Code	636
Min. Negotiated Rate	$97.69
Max. Negotiated Rate	$157.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.69

PURAPLY AM PER SQ CM

Facility

$651.25

Service Code	HCPCS Q4172
Hospital Charge Code	270676737P
Hospital Revenue Code	636
Min. Negotiated Rate	$18.50
Max. Negotiated Rate	$325.62
Rate for Payer: Aetna Commercial	$247.47
Rate for Payer: Aetna Medicare Advantage	$195.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.07
Rate for Payer: Cigna Commercial	$325.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.69
Rate for Payer: UnitedHealthcare Community & State	$20.58
Rate for Payer: Wellpoint Medicaid Managed Care	$18.50

PURAPLY AM PER SQ CM

Facility

$3,750.00

Service Code	HCPCS Q4196
Hospital Charge Code	270676737
Hospital Revenue Code	636
Min. Negotiated Rate	$106.50
Max. Negotiated Rate	$907.50
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$156.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50
Rate for Payer: UnitedHealthcare Community & State	$118.50
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$106.50

PURAPLY AM PER SQ CM

Facility

$3,750.00

Service Code	HCPCS Q4196
Hospital Charge Code	270676737
Hospital Revenue Code	636
Min. Negotiated Rate	$562.50
Max. Negotiated Rate	$907.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$907.50
Rate for Payer: Qualcare PPO/HMO/WC	$562.50

PURAPLY AM PER SQ CM JW

Facility

$651.25

Service Code	HCPCS Q4172JW
Hospital Charge Code	270676737J
Hospital Revenue Code	636
Min. Negotiated Rate	$18.50
Max. Negotiated Rate	$325.62
Rate for Payer: Aetna Commercial	$247.47
Rate for Payer: Aetna Medicare Advantage	$195.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.07
Rate for Payer: Cigna Commercial	$325.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.69
Rate for Payer: UnitedHealthcare Community & State	$20.58
Rate for Payer: Wellpoint Medicaid Managed Care	$18.50

PURAPLY AM PER SQ CM JW

Facility

$651.25

Hospital Charge Code	270676737W
Hospital Revenue Code	636
Min. Negotiated Rate	$18.50
Max. Negotiated Rate	$325.62
Rate for Payer: Aetna Commercial	$247.47
Rate for Payer: Aetna Medicare Advantage	$195.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$166.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$166.07
Rate for Payer: Cigna Commercial	$325.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.69
Rate for Payer: UnitedHealthcare Community & State	$20.58
Rate for Payer: Wellpoint Medicaid Managed Care	$18.50

PURAPLY AM PER SQ CM JW

Facility

$651.25

Service Code	HCPCS Q4172JW
Hospital Charge Code	270676737J
Hospital Revenue Code	636
Min. Negotiated Rate	$97.69
Max. Negotiated Rate	$157.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.69

PURAPLY AM PER SQ CM JW

Facility

$651.25

Hospital Charge Code	270676737W
Hospital Revenue Code	636
Min. Negotiated Rate	$97.69
Max. Negotiated Rate	$157.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$157.60
Rate for Payer: Qualcare PPO/HMO/WC	$97.69

PURAPLY WOUND MATRIX 5CM X 5CM

Facility

$6,475.00

Service Code	HCPCS Q4195
Hospital Charge Code	270681826
Hospital Revenue Code	278
Min. Negotiated Rate	$140.45
Max. Negotiated Rate	$1,566.95
Rate for Payer: Aetna Commercial	$402.12
Rate for Payer: Aetna Medicare Advantage	$479.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$536.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$147.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$536.29
Rate for Payer: Cigna Commercial	$296.35
Rate for Payer: Cigna Medicare Advantage	$147.84
Rate for Payer: Clover Medicare Advantage	$140.45
Rate for Payer: EmblemHealth Commercial	$443.52
Rate for Payer: Humana Medicare Advantage	$152.28
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$147.84
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: Qualcare PPO/HMO/WC	$971.25
Rate for Payer: UnitedHealthcare Community & State	$204.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$147.84
Rate for Payer: Wellcare Medicare Advantage	$147.84
Rate for Payer: Wellpoint Medicaid Managed Care	$183.89

PURAPLY WOUND MATRIX 5CM X 5CM

Facility

$6,475.00

Service Code	HCPCS Q4195
Hospital Charge Code	270681826
Hospital Revenue Code	278
Min. Negotiated Rate	$971.25
Max. Negotiated Rate	$1,566.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,295.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,566.95
Rate for Payer: Qualcare PPO/HMO/WC	$971.25

PUREBONE CORTICAL FIBERS 5CC

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270696103
Hospital Revenue Code	278
Min. Negotiated Rate	$92.30
Max. Negotiated Rate	$1,625.00
Rate for Payer: Aetna Commercial	$1,235.00
Rate for Payer: Aetna Medicare Advantage	$975.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$828.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$828.75
Rate for Payer: Cigna Commercial	$1,625.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50
Rate for Payer: UnitedHealthcare Community & State	$102.70
Rate for Payer: Wellpoint Medicaid Managed Care	$92.30

PUREBONE CORTICAL FIBERS 5CC

Facility

$3,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270696103
Hospital Revenue Code	278
Min. Negotiated Rate	$487.50
Max. Negotiated Rate	$786.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$786.50
Rate for Payer: Qualcare PPO/HMO/WC	$487.50

PURMARROW-360

Facility

$2,875.00

Hospital Charge Code	270702346
Hospital Revenue Code	278
Min. Negotiated Rate	$81.65
Max. Negotiated Rate	$1,437.50
Rate for Payer: Aetna Commercial	$1,092.50
Rate for Payer: Aetna Medicare Advantage	$862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$733.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$733.12
Rate for Payer: Cigna Commercial	$1,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25
Rate for Payer: UnitedHealthcare Community & State	$90.85
Rate for Payer: Wellpoint Medicaid Managed Care	$81.65

PURMARROW-360

Facility

$2,875.00

Hospital Charge Code	270702346
Hospital Revenue Code	278
Min. Negotiated Rate	$431.25
Max. Negotiated Rate	$695.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$695.75
Rate for Payer: Qualcare PPO/HMO/WC	$431.25

PUSHER MT COIL MT PULM 401216

Facility

$694.45

Service Code	HCPCS C1884
Hospital Charge Code	270627378N
Hospital Revenue Code	278
Min. Negotiated Rate	$104.17
Max. Negotiated Rate	$168.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$138.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$168.06
Rate for Payer: Qualcare PPO/HMO/WC	$104.17

Know your out-of-pocket cost for care.

All Charges