Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

RANEXA 500MG TAB

Facility

$37.05

Service Code	NDC 61958100301
Hospital Charge Code	60635580
Hospital Revenue Code	250
Min. Negotiated Rate	$5.56
Max. Negotiated Rate	$5.56
Rate for Payer: Qualcare PPO/HMO/WC	$5.56

RANEY CLIP APPLIER

Facility

$85.00

Hospital Charge Code	270335531
Hospital Revenue Code	272
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$42.50
Rate for Payer: Aetna Commercial	$32.30
Rate for Payer: Aetna Medicare Advantage	$25.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.68
Rate for Payer: Cigna Commercial	$42.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.10
Rate for Payer: Oxford Commercial	$17.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.75
Rate for Payer: UnitedHealthcare Commercial	$17.00
Rate for Payer: UnitedHealthcare Community & State	$2.69
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

RANEY CLIP APPLIER

Facility

$85.00

Hospital Charge Code	270335531
Hospital Revenue Code	272
Min. Negotiated Rate	$12.75
Max. Negotiated Rate	$12.75
Rate for Payer: Qualcare PPO/HMO/WC	$12.75

RANEY CLIPS

Facility

$52.00

Hospital Charge Code	270335100
Hospital Revenue Code	272
Min. Negotiated Rate	$7.80
Max. Negotiated Rate	$7.80
Rate for Payer: Qualcare PPO/HMO/WC	$7.80

RANEY CLIPS

Facility

$52.00

Hospital Charge Code	270335100
Hospital Revenue Code	272
Min. Negotiated Rate	$1.48
Max. Negotiated Rate	$26.00
Rate for Payer: Aetna Commercial	$19.76
Rate for Payer: Aetna Medicare Advantage	$15.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.26
Rate for Payer: Cigna Commercial	$26.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.52
Rate for Payer: Oxford Commercial	$10.40
Rate for Payer: Qualcare PPO/HMO/WC	$7.80
Rate for Payer: UnitedHealthcare Commercial	$10.40
Rate for Payer: UnitedHealthcare Community & State	$1.64
Rate for Payer: Wellpoint Medicaid Managed Care	$1.48

RANFAC CHOLANGIOGRAM CATH

Facility

$172.00

Hospital Charge Code	270335123
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

RANFAC CHOLANGIOGRAM CATH

Facility

$172.00

Hospital Charge Code	270335123
Hospital Revenue Code	272
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$65.36
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.72
Rate for Payer: Oxford Commercial	$34.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$34.40
Rate for Payer: UnitedHealthcare Community & State	$5.44
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

RANITIDINE 150MG CAPSULE

Facility

$9.92

Service Code	NDC 27241010950
Hospital Charge Code	606390300
Hospital Revenue Code	250
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.96
Rate for Payer: Aetna Commercial	$3.77
Rate for Payer: Aetna Medicare Advantage	$2.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.53
Rate for Payer: Cigna Commercial	$4.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.58
Rate for Payer: Oxford Commercial	$1.98
Rate for Payer: Qualcare PPO/HMO/WC	$1.49
Rate for Payer: UnitedHealthcare Commercial	$1.98
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

RANITIDINE 150MG CAPSULE

Facility

$9.92

Service Code	NDC 27241010950
Hospital Charge Code	606390300
Hospital Revenue Code	250
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$1.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.49

RANITIDINE SYRUP 150MG

Facility

$54.34

Service Code	NDC 68094020459
Hospital Charge Code	60635067
Hospital Revenue Code	250
Min. Negotiated Rate	$1.54
Max. Negotiated Rate	$27.17
Rate for Payer: Aetna Commercial	$20.65
Rate for Payer: Aetna Medicare Advantage	$16.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.86
Rate for Payer: Cigna Commercial	$27.17
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.13
Rate for Payer: Oxford Commercial	$10.87
Rate for Payer: Qualcare PPO/HMO/WC	$8.15
Rate for Payer: UnitedHealthcare Commercial	$10.87
Rate for Payer: UnitedHealthcare Community & State	$1.72
Rate for Payer: Wellpoint Medicaid Managed Care	$1.54

RANITIDINE SYRUP 150MG

Facility

$54.34

Service Code	NDC 68094020459
Hospital Charge Code	60635067
Hospital Revenue Code	250
Min. Negotiated Rate	$8.15
Max. Negotiated Rate	$8.15
Rate for Payer: Qualcare PPO/HMO/WC	$8.15

RANOLAZINE 200MG CAP

Facility

$149.15

Hospital Charge Code	6063943169
Hospital Revenue Code	250
Min. Negotiated Rate	$4.24
Max. Negotiated Rate	$74.58
Rate for Payer: Aetna Commercial	$56.68
Rate for Payer: Aetna Medicare Advantage	$44.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$38.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$38.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$38.03
Rate for Payer: Cigna Commercial	$74.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.78
Rate for Payer: Oxford Commercial	$29.83
Rate for Payer: Qualcare PPO/HMO/WC	$22.37
Rate for Payer: UnitedHealthcare Commercial	$29.83
Rate for Payer: UnitedHealthcare Community & State	$4.71
Rate for Payer: Wellpoint Medicaid Managed Care	$4.24

RANOLAZINE 200MG CAP

Facility

$149.15

Hospital Charge Code	6063943169
Hospital Revenue Code	250
Min. Negotiated Rate	$22.37
Max. Negotiated Rate	$22.37
Rate for Payer: Qualcare PPO/HMO/WC	$22.37

RAPID FLU A AND B

Facility

$629.98

Service Code	HCPCS 87804
Hospital Charge Code	3036053
Hospital Revenue Code	306
Min. Negotiated Rate	$94.50
Max. Negotiated Rate	$94.50
Rate for Payer: Qualcare PPO/HMO/WC	$94.50

RAPID FLU A AND B

Facility

$629.98

Service Code	HCPCS 87804
Hospital Charge Code	3036053
Hospital Revenue Code	306
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$314.99
Rate for Payer: Aetna Commercial	$45.02
Rate for Payer: Aetna Medicare Advantage	$53.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.04
Rate for Payer: Cigna Commercial	$314.99
Rate for Payer: Cigna Medicare Advantage	$16.55
Rate for Payer: Clover Medicare Advantage	$15.72
Rate for Payer: EmblemHealth Commercial	$49.65
Rate for Payer: Humana Medicare Advantage	$17.05
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.79
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$94.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.24
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.55
Rate for Payer: Wellcare Medicare Advantage	$16.55
Rate for Payer: Wellpoint Medicaid Managed Care	$17.89

RAPID PLASMA REAGIN (RPR),QT

Facility

$141.00

Service Code	HCPCS 86593
Hospital Charge Code	38476024
Hospital Revenue Code	302
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$11.97
Rate for Payer: Aetna Medicare Advantage	$14.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$4.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.96
Rate for Payer: Cigna Commercial	$70.50
Rate for Payer: Cigna Medicare Advantage	$4.40
Rate for Payer: Clover Medicare Advantage	$4.18
Rate for Payer: EmblemHealth Commercial	$13.20
Rate for Payer: Humana Medicare Advantage	$4.53
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$4.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$36.66
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$21.15
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$3.52
Rate for Payer: UnitedHealthcare Medicare Advantage	$4.40
Rate for Payer: Wellcare Medicare Advantage	$4.40
Rate for Payer: Wellpoint Medicaid Managed Care	$4.00

RAPID PLASMA REAGIN (RPR),QT

Facility

$141.00

Service Code	HCPCS 86593
Hospital Charge Code	38476024
Hospital Revenue Code	302
Min. Negotiated Rate	$21.15
Max. Negotiated Rate	$21.15
Rate for Payer: Qualcare PPO/HMO/WC	$21.15

RAPID RHINO 5.5 NON-INF

Facility

$155.00

Hospital Charge Code	270654032
Hospital Revenue Code	272
Min. Negotiated Rate	$4.40
Max. Negotiated Rate	$77.50
Rate for Payer: Aetna Commercial	$58.90
Rate for Payer: Aetna Medicare Advantage	$46.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$39.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$39.52
Rate for Payer: Cigna Commercial	$77.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$40.30
Rate for Payer: Oxford Commercial	$31.00
Rate for Payer: Qualcare PPO/HMO/WC	$23.25
Rate for Payer: UnitedHealthcare Commercial	$31.00
Rate for Payer: UnitedHealthcare Community & State	$4.90
Rate for Payer: Wellpoint Medicaid Managed Care	$4.40

RAPID RHINO 5.5 NON-INF

Facility

$155.00

Hospital Charge Code	270654032
Hospital Revenue Code	272
Min. Negotiated Rate	$23.25
Max. Negotiated Rate	$23.25
Rate for Payer: Qualcare PPO/HMO/WC	$23.25

RAPID STREP A

Facility

$618.59

Service Code	HCPCS 87430
Hospital Charge Code	3036054
Hospital Revenue Code	306
Min. Negotiated Rate	$10.30
Max. Negotiated Rate	$309.30
Rate for Payer: Aetna Commercial	$45.72
Rate for Payer: Aetna Medicare Advantage	$54.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$60.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$60.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$10.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$60.98
Rate for Payer: Cigna Commercial	$309.30
Rate for Payer: Cigna Medicare Advantage	$16.81
Rate for Payer: Clover Medicare Advantage	$15.97
Rate for Payer: EmblemHealth Commercial	$50.43
Rate for Payer: Humana Medicare Advantage	$17.31
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$160.83
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$92.79
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$13.45
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.81
Rate for Payer: Wellcare Medicare Advantage	$16.81
Rate for Payer: Wellpoint Medicaid Managed Care	$17.57

RAPID STREP A

Facility

$618.59

Service Code	HCPCS 87430
Hospital Charge Code	3036054
Hospital Revenue Code	306
Min. Negotiated Rate	$92.79
Max. Negotiated Rate	$92.79
Rate for Payer: Qualcare PPO/HMO/WC	$92.79

RAP-RHINO STAMMBERGER FOAM DRE

Facility

$120.00

Hospital Charge Code	270339116
Hospital Revenue Code	272
Min. Negotiated Rate	$3.41
Max. Negotiated Rate	$60.00
Rate for Payer: Aetna Commercial	$45.60
Rate for Payer: Aetna Medicare Advantage	$36.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$30.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$30.60
Rate for Payer: Cigna Commercial	$60.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$31.20
Rate for Payer: Oxford Commercial	$24.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00
Rate for Payer: UnitedHealthcare Commercial	$24.00
Rate for Payer: UnitedHealthcare Community & State	$3.79
Rate for Payer: Wellpoint Medicaid Managed Care	$3.41

RAP-RHINO STAMMBERGER FOAM DRE

Facility

$120.00

Hospital Charge Code	270339116
Hospital Revenue Code	272
Min. Negotiated Rate	$18.00
Max. Negotiated Rate	$18.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.00

RA-RIGHT ATRIUM

Facility

$1,500.00

Hospital Charge Code	270702433
Hospital Revenue Code	278
Min. Negotiated Rate	$42.60
Max. Negotiated Rate	$750.00
Rate for Payer: Aetna Commercial	$570.00
Rate for Payer: Aetna Medicare Advantage	$450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$382.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$382.50
Rate for Payer: Cigna Commercial	$750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00
Rate for Payer: UnitedHealthcare Community & State	$47.40
Rate for Payer: Wellpoint Medicaid Managed Care	$42.60

RA-RIGHT ATRIUM

Facility

$1,500.00

Hospital Charge Code	270702433
Hospital Revenue Code	278
Min. Negotiated Rate	$225.00
Max. Negotiated Rate	$363.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$363.00
Rate for Payer: Qualcare PPO/HMO/WC	$225.00

Know your out-of-pocket cost for care.

All Charges