Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

SOLUTION EKG EXG-SOL 4 OZ

Facility

$55.00

Hospital Charge Code	270331297
Hospital Revenue Code	272
Min. Negotiated Rate	$8.25
Max. Negotiated Rate	$8.25
Rate for Payer: Qualcare PPO/HMO/WC	$8.25

SOLUTION EKG EXG-SOL 4 OZ

Facility

$55.00

Hospital Charge Code	270331297
Hospital Revenue Code	272
Min. Negotiated Rate	$1.56
Max. Negotiated Rate	$27.50
Rate for Payer: Aetna Commercial	$20.90
Rate for Payer: Aetna Medicare Advantage	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.03
Rate for Payer: Cigna Commercial	$27.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.30
Rate for Payer: Oxford Commercial	$11.00
Rate for Payer: Qualcare PPO/HMO/WC	$8.25
Rate for Payer: UnitedHealthcare Commercial	$11.00
Rate for Payer: UnitedHealthcare Community & State	$1.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.56

SOLUTION GLYCINE 1.5% 3000ML

Facility

$60.45

Hospital Charge Code	270061490
Hospital Revenue Code	270
Min. Negotiated Rate	$9.07
Max. Negotiated Rate	$9.07
Rate for Payer: Qualcare PPO/HMO/WC	$9.07

SOLUTION GLYCINE 1.5% 3000ML

Facility

$60.45

Hospital Charge Code	270061490
Hospital Revenue Code	270
Min. Negotiated Rate	$1.72
Max. Negotiated Rate	$30.23
Rate for Payer: Aetna Commercial	$22.97
Rate for Payer: Aetna Medicare Advantage	$18.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.41
Rate for Payer: Cigna Commercial	$30.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.72
Rate for Payer: Oxford Commercial	$12.09
Rate for Payer: Qualcare PPO/HMO/WC	$9.07
Rate for Payer: UnitedHealthcare Commercial	$12.09
Rate for Payer: UnitedHealthcare Community & State	$1.91
Rate for Payer: Wellpoint Medicaid Managed Care	$1.72

SOLUTION HYDROGEN PEROXIDE 3%

Facility

$55.45

Hospital Charge Code	270649477
Hospital Revenue Code	270
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$8.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.32

SOLUTION HYDROGEN PEROXIDE 3%

Facility

$55.45

Hospital Charge Code	270649477
Hospital Revenue Code	270
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$27.73
Rate for Payer: Aetna Commercial	$21.07
Rate for Payer: Aetna Medicare Advantage	$16.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.14
Rate for Payer: Cigna Commercial	$27.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.42
Rate for Payer: Oxford Commercial	$11.09
Rate for Payer: Qualcare PPO/HMO/WC	$8.32
Rate for Payer: UnitedHealthcare Commercial	$11.09
Rate for Payer: UnitedHealthcare Community & State	$1.75
Rate for Payer: Wellpoint Medicaid Managed Care	$1.57

SOLUTION POTASSIUM CHLORIDE

Facility

$83.00

Hospital Charge Code	270331404
Hospital Revenue Code	272
Min. Negotiated Rate	$2.36
Max. Negotiated Rate	$41.50
Rate for Payer: Aetna Commercial	$31.54
Rate for Payer: Aetna Medicare Advantage	$24.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.16
Rate for Payer: Cigna Commercial	$41.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.58
Rate for Payer: Oxford Commercial	$16.60
Rate for Payer: Qualcare PPO/HMO/WC	$12.45
Rate for Payer: UnitedHealthcare Commercial	$16.60
Rate for Payer: UnitedHealthcare Community & State	$2.62
Rate for Payer: Wellpoint Medicaid Managed Care	$2.36

SOLUTION POTASSIUM CHLORIDE

Facility

$83.00

Hospital Charge Code	270331404
Hospital Revenue Code	272
Min. Negotiated Rate	$12.45
Max. Negotiated Rate	$12.45
Rate for Payer: Qualcare PPO/HMO/WC	$12.45

SOLUTION STERILE 2000ML

Facility

$27.66

Hospital Charge Code	270690942
Hospital Revenue Code	270
Min. Negotiated Rate	$4.15
Max. Negotiated Rate	$4.15
Rate for Payer: Qualcare PPO/HMO/WC	$4.15

SOLUTION STERILE 2000ML

Facility

$27.66

Hospital Charge Code	270690942
Hospital Revenue Code	270
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$13.83
Rate for Payer: Aetna Commercial	$10.51
Rate for Payer: Aetna Medicare Advantage	$8.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.05
Rate for Payer: Cigna Commercial	$13.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.19
Rate for Payer: Oxford Commercial	$5.53
Rate for Payer: Qualcare PPO/HMO/WC	$4.15
Rate for Payer: UnitedHealthcare Commercial	$5.53
Rate for Payer: UnitedHealthcare Community & State	$0.87
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

SOLUTION STERILE WATER 2000ML

Facility

$39.62

Hospital Charge Code	270690943
Hospital Revenue Code	270
Min. Negotiated Rate	$5.94
Max. Negotiated Rate	$5.94
Rate for Payer: Qualcare PPO/HMO/WC	$5.94

SOLUTION STERILE WATER 2000ML

Facility

$39.62

Hospital Charge Code	270690943
Hospital Revenue Code	270
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$19.81
Rate for Payer: Aetna Commercial	$15.06
Rate for Payer: Aetna Medicare Advantage	$11.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.10
Rate for Payer: Cigna Commercial	$19.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.30
Rate for Payer: Oxford Commercial	$7.92
Rate for Payer: Qualcare PPO/HMO/WC	$5.94
Rate for Payer: UnitedHealthcare Commercial	$7.92
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.13

SOLUTION WATER STERILE 2000ML

Facility

$28.50

Hospital Charge Code	270690933
Hospital Revenue Code	270
Min. Negotiated Rate	$4.28
Max. Negotiated Rate	$4.28
Rate for Payer: Qualcare PPO/HMO/WC	$4.28

SOLUTION WATER STERILE 2000ML

Facility

$28.50

Hospital Charge Code	270690933
Hospital Revenue Code	270
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$14.25
Rate for Payer: Aetna Commercial	$10.83
Rate for Payer: Aetna Medicare Advantage	$8.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.27
Rate for Payer: Cigna Commercial	$14.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.41
Rate for Payer: Oxford Commercial	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$4.28
Rate for Payer: UnitedHealthcare Commercial	$5.70
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

SOMATOMEDIN C

Facility

$613.00

Service Code	HCPCS 84305
Hospital Charge Code	38473084
Hospital Revenue Code	301
Min. Negotiated Rate	$91.95
Max. Negotiated Rate	$91.95
Rate for Payer: Qualcare PPO/HMO/WC	$91.95

SOMATOMEDIN C

Facility

$613.00

Service Code	HCPCS 84305
Hospital Charge Code	38473084
Hospital Revenue Code	301
Min. Negotiated Rate	$17.01
Max. Negotiated Rate	$306.50
Rate for Payer: Aetna Commercial	$57.83
Rate for Payer: Aetna Medicare Advantage	$68.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$21.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.12
Rate for Payer: Cigna Commercial	$306.50
Rate for Payer: Cigna Medicare Advantage	$21.26
Rate for Payer: Clover Medicare Advantage	$20.20
Rate for Payer: EmblemHealth Commercial	$63.78
Rate for Payer: Humana Medicare Advantage	$21.90
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$21.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.38
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$91.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$17.01
Rate for Payer: UnitedHealthcare Medicare Advantage	$21.26
Rate for Payer: Wellcare Medicare Advantage	$21.26
Rate for Payer: Wellpoint Medicaid Managed Care	$17.41

SOMATOSTATIN

Facility

$125.65

Service Code	HCPCS 84307
Hospital Charge Code	39900452
Hospital Revenue Code	301
Min. Negotiated Rate	$3.57
Max. Negotiated Rate	$723.02
Rate for Payer: Aetna Commercial	$49.72
Rate for Payer: Aetna Medicare Advantage	$59.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.31
Rate for Payer: Cigna Commercial	$62.83
Rate for Payer: Cigna Medicare Advantage	$18.28
Rate for Payer: Clover Medicare Advantage	$17.37
Rate for Payer: EmblemHealth Commercial	$54.84
Rate for Payer: Humana Medicare Advantage	$18.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.67
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.85
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.28
Rate for Payer: Wellcare Medicare Advantage	$18.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$723.02
Rate for Payer: Wellpoint Medicaid Managed Care	$3.57

SOMATOSTATIN

Facility

$129.00

Service Code	HCPCS 84307
Hospital Charge Code	38477152
Hospital Revenue Code	301
Min. Negotiated Rate	$3.66
Max. Negotiated Rate	$723.02
Rate for Payer: Aetna Commercial	$49.72
Rate for Payer: Aetna Medicare Advantage	$59.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$26.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.31
Rate for Payer: Cigna Commercial	$64.50
Rate for Payer: Cigna Medicare Advantage	$18.28
Rate for Payer: Clover Medicare Advantage	$17.37
Rate for Payer: EmblemHealth Commercial	$54.84
Rate for Payer: Humana Medicare Advantage	$18.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.54
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$19.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.62
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.28
Rate for Payer: Wellcare Medicare Advantage	$18.28
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$723.02
Rate for Payer: Wellpoint Medicaid Managed Care	$3.66

SOMATOSTATIN

Facility

$125.65

Service Code	HCPCS 84307
Hospital Charge Code	39900452
Hospital Revenue Code	301
Min. Negotiated Rate	$18.85
Max. Negotiated Rate	$18.85
Rate for Payer: Qualcare PPO/HMO/WC	$18.85

SOMATOSTATIN

Facility

$129.00

Service Code	HCPCS 84307
Hospital Charge Code	38477152
Hospital Revenue Code	301
Min. Negotiated Rate	$19.35
Max. Negotiated Rate	$19.35
Rate for Payer: Qualcare PPO/HMO/WC	$19.35

SOMBRERO PATELLA SZ4 7x37MM

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675368
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

SOMBRERO PATELLA SZ4 7x37MM

Facility

$1,500.00

Service Code	HCPCS C1776
Hospital Charge Code	270675368
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

SONGER CRIMP

Facility

$412.50

Hospital Charge Code	270662291
Hospital Revenue Code	272
Min. Negotiated Rate	$61.88
Max. Negotiated Rate	$61.88
Rate for Payer: Qualcare PPO/HMO/WC	$61.88

SONGER CRIMP

Facility

$412.50

Hospital Charge Code	270662291
Hospital Revenue Code	272
Min. Negotiated Rate	$11.71
Max. Negotiated Rate	$206.25
Rate for Payer: Aetna Commercial	$156.75
Rate for Payer: Aetna Medicare Advantage	$123.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$105.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$105.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$105.19
Rate for Payer: Cigna Commercial	$206.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$107.25
Rate for Payer: Oxford Commercial	$82.50
Rate for Payer: Qualcare PPO/HMO/WC	$61.88
Rate for Payer: UnitedHealthcare Commercial	$82.50
Rate for Payer: UnitedHealthcare Community & State	$13.04
Rate for Payer: Wellpoint Medicaid Managed Care	$11.71

SONIC TURBO MINI FLARED

Facility

$375.00

Hospital Charge Code	270660134
Hospital Revenue Code	272
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$56.25
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

Know your out-of-pocket cost for care.

All Charges