Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BANDAGE COBAN 4

Facility

$8.46

Hospital Charge Code	270300165
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$1.27

BANDAGE COBAN 4

Facility

$8.46

Hospital Charge Code	270300165
Hospital Revenue Code	272
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.23
Rate for Payer: Aetna Commercial	$3.21
Rate for Payer: Aetna Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.16
Rate for Payer: Cigna Commercial	$4.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.20
Rate for Payer: Oxford Commercial	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.27
Rate for Payer: UnitedHealthcare Commercial	$1.69
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

BANDAGE COBAN 4

Facility

$8.46

Hospital Charge Code	270300165W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$1.27
Rate for Payer: Qualcare PPO/HMO/WC	$1.27

BANDAGE COBAN ELASTIC 6 5YD

Facility

$19.81

Hospital Charge Code	270651441
Hospital Revenue Code	270
Min. Negotiated Rate	$0.56
Max. Negotiated Rate	$9.90
Rate for Payer: Aetna Commercial	$7.53
Rate for Payer: Aetna Medicare Advantage	$5.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.05
Rate for Payer: Cigna Commercial	$9.90
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.15
Rate for Payer: Oxford Commercial	$3.96
Rate for Payer: Qualcare PPO/HMO/WC	$2.97
Rate for Payer: UnitedHealthcare Commercial	$3.96
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.56

BANDAGE COBAN ELASTIC 6 5YD

Facility

$19.81

Hospital Charge Code	270651441
Hospital Revenue Code	270
Min. Negotiated Rate	$2.97
Max. Negotiated Rate	$2.97
Rate for Payer: Qualcare PPO/HMO/WC	$2.97

BANDAGE D-STAT HEMOSTATIC 3000

Facility

$245.00

Hospital Charge Code	270632910
Hospital Revenue Code	270
Min. Negotiated Rate	$6.96
Max. Negotiated Rate	$122.50
Rate for Payer: Aetna Commercial	$93.10
Rate for Payer: Aetna Medicare Advantage	$73.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$62.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$62.48
Rate for Payer: Cigna Commercial	$122.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$63.70
Rate for Payer: Oxford Commercial	$49.00
Rate for Payer: Qualcare PPO/HMO/WC	$36.75
Rate for Payer: UnitedHealthcare Commercial	$49.00
Rate for Payer: UnitedHealthcare Community & State	$7.74
Rate for Payer: Wellpoint Medicaid Managed Care	$6.96

BANDAGE D-STAT HEMOSTATIC 3000

Facility

$245.00

Hospital Charge Code	270632910
Hospital Revenue Code	270
Min. Negotiated Rate	$36.75
Max. Negotiated Rate	$36.75
Rate for Payer: Qualcare PPO/HMO/WC	$36.75

BANDAGE ELASTIC 2

Facility

$6.31

Hospital Charge Code	270649712
Hospital Revenue Code	270
Min. Negotiated Rate	$0.95
Max. Negotiated Rate	$0.95
Rate for Payer: Qualcare PPO/HMO/WC	$0.95

BANDAGE ELASTIC 2

Facility

$6.31

Hospital Charge Code	270649712
Hospital Revenue Code	270
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.15
Rate for Payer: Aetna Commercial	$2.40
Rate for Payer: Aetna Medicare Advantage	$1.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.61
Rate for Payer: Cigna Commercial	$3.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.64
Rate for Payer: Oxford Commercial	$1.26
Rate for Payer: Qualcare PPO/HMO/WC	$0.95
Rate for Payer: UnitedHealthcare Commercial	$1.26
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

BANDAGE ELASTIC 3

Facility

$5.96

Hospital Charge Code	270649713
Hospital Revenue Code	270
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$2.98
Rate for Payer: Aetna Commercial	$2.26
Rate for Payer: Aetna Medicare Advantage	$1.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.52
Rate for Payer: Cigna Commercial	$2.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.55
Rate for Payer: Oxford Commercial	$1.19
Rate for Payer: Qualcare PPO/HMO/WC	$0.89
Rate for Payer: UnitedHealthcare Commercial	$1.19
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

BANDAGE ELASTIC 3

Facility

$5.96

Hospital Charge Code	270649713
Hospital Revenue Code	270
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$0.89
Rate for Payer: Qualcare PPO/HMO/WC	$0.89

BANDAGE ELASTIC 4 INCH

Facility

$2.99

Hospital Charge Code	270649780
Hospital Revenue Code	272
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.50
Rate for Payer: Aetna Commercial	$1.14
Rate for Payer: Aetna Medicare Advantage	$0.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.76
Rate for Payer: Cigna Commercial	$1.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.78
Rate for Payer: Oxford Commercial	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.45
Rate for Payer: UnitedHealthcare Commercial	$0.60
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

BANDAGE ELASTIC 4 INCH

Facility

$2.99

Hospital Charge Code	270649780
Hospital Revenue Code	272
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.45

BANDAGE ELASTIC 6IN

Facility

$127.90

Hospital Charge Code	270649776
Hospital Revenue Code	270
Min. Negotiated Rate	$3.63
Max. Negotiated Rate	$63.95
Rate for Payer: Aetna Commercial	$48.60
Rate for Payer: Aetna Medicare Advantage	$38.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.61
Rate for Payer: Cigna Commercial	$63.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.25
Rate for Payer: Oxford Commercial	$25.58
Rate for Payer: Qualcare PPO/HMO/WC	$19.18
Rate for Payer: UnitedHealthcare Commercial	$25.58
Rate for Payer: UnitedHealthcare Community & State	$4.04
Rate for Payer: Wellpoint Medicaid Managed Care	$3.63

BANDAGE ELASTIC 6IN

Facility

$127.90

Hospital Charge Code	270649776
Hospital Revenue Code	270
Min. Negotiated Rate	$19.18
Max. Negotiated Rate	$19.18
Rate for Payer: Qualcare PPO/HMO/WC	$19.18

BANDAGE ELASTIC W/VELCRO 2

Facility

$143.27

Hospital Charge Code	270655618
Hospital Revenue Code	272
Min. Negotiated Rate	$21.49
Max. Negotiated Rate	$21.49
Rate for Payer: Qualcare PPO/HMO/WC	$21.49

BANDAGE ELASTIC W/VELCRO 2

Facility

$143.27

Hospital Charge Code	270655618
Hospital Revenue Code	272
Min. Negotiated Rate	$4.07
Max. Negotiated Rate	$71.64
Rate for Payer: Aetna Commercial	$54.44
Rate for Payer: Aetna Medicare Advantage	$42.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$36.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$36.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$36.53
Rate for Payer: Cigna Commercial	$71.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.25
Rate for Payer: Oxford Commercial	$28.65
Rate for Payer: Qualcare PPO/HMO/WC	$21.49
Rate for Payer: UnitedHealthcare Commercial	$28.65
Rate for Payer: UnitedHealthcare Community & State	$4.53
Rate for Payer: Wellpoint Medicaid Managed Care	$4.07

BANDAGE ELASTIC W/VELCRO 3

Facility

$16.80

Hospital Charge Code	270655015
Hospital Revenue Code	272
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$2.52
Rate for Payer: Qualcare PPO/HMO/WC	$2.52

BANDAGE ELASTIC W/VELCRO 3

Facility

$16.80

Hospital Charge Code	270655015
Hospital Revenue Code	272
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$8.40
Rate for Payer: Aetna Commercial	$6.38
Rate for Payer: Aetna Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.28
Rate for Payer: Cigna Commercial	$8.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.37
Rate for Payer: Oxford Commercial	$3.36
Rate for Payer: Qualcare PPO/HMO/WC	$2.52
Rate for Payer: UnitedHealthcare Commercial	$3.36
Rate for Payer: UnitedHealthcare Community & State	$0.53
Rate for Payer: Wellpoint Medicaid Managed Care	$0.48

BANDAGE ELASTIC W/VELCRO 4

Facility

$18.65

Hospital Charge Code	270655622
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$9.32
Rate for Payer: Aetna Commercial	$7.09
Rate for Payer: Aetna Medicare Advantage	$5.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.76
Rate for Payer: Cigna Commercial	$9.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.85
Rate for Payer: Oxford Commercial	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.80
Rate for Payer: UnitedHealthcare Commercial	$3.73
Rate for Payer: UnitedHealthcare Community & State	$0.59
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

BANDAGE ELASTIC W/VELCRO 4

Facility

$18.65

Hospital Charge Code	270655622
Hospital Revenue Code	272
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.80

BANDAGE ESMARK

Facility

$5.23

Hospital Charge Code	270600369
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$2.62
Rate for Payer: Aetna Commercial	$1.99
Rate for Payer: Aetna Medicare Advantage	$1.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.33
Rate for Payer: Cigna Commercial	$2.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.36
Rate for Payer: Oxford Commercial	$1.05
Rate for Payer: Qualcare PPO/HMO/WC	$0.78
Rate for Payer: UnitedHealthcare Commercial	$1.05
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

BANDAGE ESMARK

Facility

$5.23

Hospital Charge Code	270600369
Hospital Revenue Code	272
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$0.78
Rate for Payer: Qualcare PPO/HMO/WC	$0.78

BANDAGE ESMARK STERILE

Facility

$14.25

Hospital Charge Code	270658527
Hospital Revenue Code	272
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$7.12
Rate for Payer: Aetna Commercial	$5.42
Rate for Payer: Aetna Medicare Advantage	$4.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.63
Rate for Payer: Cigna Commercial	$7.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.71
Rate for Payer: Oxford Commercial	$2.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.14
Rate for Payer: UnitedHealthcare Commercial	$2.85
Rate for Payer: UnitedHealthcare Community & State	$0.45
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

BANDAGE ESMARK STERILE

Facility

$10.36

Hospital Charge Code	270658525
Hospital Revenue Code	272
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$1.55
Rate for Payer: Qualcare PPO/HMO/WC	$1.55

Know your out-of-pocket cost for care.

All Charges