Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

STERILE WATER 1000 ML

Facility

$9.51

Hospital Charge Code	270600659
Hospital Revenue Code	270
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.75
Rate for Payer: Aetna Commercial	$3.61
Rate for Payer: Aetna Medicare Advantage	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.43
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.47
Rate for Payer: Oxford Commercial	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.43
Rate for Payer: UnitedHealthcare Commercial	$1.90
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

STERILE WATER 1000 ML

Facility

$9.51

Hospital Charge Code	270600659
Hospital Revenue Code	270
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.43

STERILE WATER 20 ML INJ

Facility

$20.00

Hospital Charge Code	60628550R
Hospital Revenue Code	272
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$10.00
Rate for Payer: Aetna Commercial	$7.60
Rate for Payer: Aetna Medicare Advantage	$6.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.10
Rate for Payer: Cigna Commercial	$10.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.20
Rate for Payer: Oxford Commercial	$4.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00
Rate for Payer: UnitedHealthcare Commercial	$4.00
Rate for Payer: UnitedHealthcare Community & State	$0.63
Rate for Payer: Wellpoint Medicaid Managed Care	$0.57

STERILE WATER 20 ML INJ

Facility

$20.00

Hospital Charge Code	60628550R
Hospital Revenue Code	272
Min. Negotiated Rate	$3.00
Max. Negotiated Rate	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$3.00

STERILE WATER 20 ML INJ

Facility

$6.10

Service Code	NDC 409488720
Hospital Charge Code	60628550
Hospital Revenue Code	250
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$0.92
Rate for Payer: Qualcare PPO/HMO/WC	$0.92

STERILE WATER 20 ML INJ

Facility

$6.10

Service Code	NDC 409488720
Hospital Charge Code	60628550
Hospital Revenue Code	250
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.05
Rate for Payer: Aetna Commercial	$2.32
Rate for Payer: Aetna Medicare Advantage	$1.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.56
Rate for Payer: Cigna Commercial	$3.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.59
Rate for Payer: Oxford Commercial	$1.22
Rate for Payer: Qualcare PPO/HMO/WC	$0.92
Rate for Payer: UnitedHealthcare Commercial	$1.22
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

STERILE WATER 50ML INJ

Facility

$28.54

Service Code	NDC 409488799
Hospital Charge Code	60628551
Hospital Revenue Code	250
Min. Negotiated Rate	$4.28
Max. Negotiated Rate	$4.28
Rate for Payer: Qualcare PPO/HMO/WC	$4.28

STERILE WATER 50ML INJ

Facility

$28.54

Service Code	NDC 409488799
Hospital Charge Code	60628551
Hospital Revenue Code	250
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$14.27
Rate for Payer: Aetna Commercial	$10.85
Rate for Payer: Aetna Medicare Advantage	$8.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.28
Rate for Payer: Cigna Commercial	$14.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.42
Rate for Payer: Oxford Commercial	$5.71
Rate for Payer: Qualcare PPO/HMO/WC	$4.28
Rate for Payer: UnitedHealthcare Commercial	$5.71
Rate for Payer: UnitedHealthcare Community & State	$0.90
Rate for Payer: Wellpoint Medicaid Managed Care	$0.81

STERILE WATER FOR INHALATION 2

Facility

$16.46

Hospital Charge Code	270655450
Hospital Revenue Code	270
Min. Negotiated Rate	$2.47
Max. Negotiated Rate	$2.47
Rate for Payer: Qualcare PPO/HMO/WC	$2.47

STERILE WATER FOR INHALATION 2

Facility

$16.46

Hospital Charge Code	270655450
Hospital Revenue Code	270
Min. Negotiated Rate	$0.47
Max. Negotiated Rate	$8.23
Rate for Payer: Aetna Commercial	$6.25
Rate for Payer: Aetna Medicare Advantage	$4.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.20
Rate for Payer: Cigna Commercial	$8.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.28
Rate for Payer: Oxford Commercial	$3.29
Rate for Payer: Qualcare PPO/HMO/WC	$2.47
Rate for Payer: UnitedHealthcare Commercial	$3.29
Rate for Payer: UnitedHealthcare Community & State	$0.52
Rate for Payer: Wellpoint Medicaid Managed Care	$0.47

STERILIZATION CASE CHONDRO PIC

Facility

$2,075.00

Hospital Charge Code	270689603
Hospital Revenue Code	272
Min. Negotiated Rate	$311.25
Max. Negotiated Rate	$311.25
Rate for Payer: Qualcare PPO/HMO/WC	$311.25

STERILIZATION CASE CHONDRO PIC

Facility

$2,075.00

Hospital Charge Code	270689603
Hospital Revenue Code	272
Min. Negotiated Rate	$58.93
Max. Negotiated Rate	$1,037.50
Rate for Payer: Aetna Commercial	$788.50
Rate for Payer: Aetna Medicare Advantage	$622.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$529.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$529.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$529.12
Rate for Payer: Cigna Commercial	$1,037.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$539.50
Rate for Payer: Oxford Commercial	$415.00
Rate for Payer: Qualcare PPO/HMO/WC	$311.25
Rate for Payer: UnitedHealthcare Commercial	$415.00
Rate for Payer: UnitedHealthcare Community & State	$65.57
Rate for Payer: Wellpoint Medicaid Managed Care	$58.93

STERIS 3085 SP BATTERY POWERED

Facility

$174,074.10

Hospital Charge Code	270663229
Hospital Revenue Code	270
Min. Negotiated Rate	$4,943.70
Max. Negotiated Rate	$87,037.05
Rate for Payer: Aetna Commercial	$66,148.16
Rate for Payer: Aetna Medicare Advantage	$52,222.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44,388.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44,388.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44,388.90
Rate for Payer: Cigna Commercial	$87,037.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45,259.27
Rate for Payer: Oxford Commercial	$34,814.82
Rate for Payer: Qualcare PPO/HMO/WC	$26,111.12
Rate for Payer: UnitedHealthcare Commercial	$34,814.82
Rate for Payer: UnitedHealthcare Community & State	$5,500.74
Rate for Payer: Wellpoint Medicaid Managed Care	$4,943.70

STERIS 3085 SP BATTERY POWERED

Facility

$174,074.10

Hospital Charge Code	270663229
Hospital Revenue Code	270
Min. Negotiated Rate	$26,111.12
Max. Negotiated Rate	$26,111.12
Rate for Payer: Qualcare PPO/HMO/WC	$26,111.12

STERI STRIP 1

Facility

$197.10

Hospital Charge Code	270663693
Hospital Revenue Code	270
Min. Negotiated Rate	$5.60
Max. Negotiated Rate	$98.55
Rate for Payer: Aetna Commercial	$74.90
Rate for Payer: Aetna Medicare Advantage	$59.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$50.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$50.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$50.26
Rate for Payer: Cigna Commercial	$98.55
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$51.25
Rate for Payer: Oxford Commercial	$39.42
Rate for Payer: Qualcare PPO/HMO/WC	$29.57
Rate for Payer: UnitedHealthcare Commercial	$39.42
Rate for Payer: UnitedHealthcare Community & State	$6.23
Rate for Payer: Wellpoint Medicaid Managed Care	$5.60

STERI STRIP 1

Facility

$197.10

Hospital Charge Code	270663693
Hospital Revenue Code	270
Min. Negotiated Rate	$29.57
Max. Negotiated Rate	$29.57
Rate for Payer: Qualcare PPO/HMO/WC	$29.57

STERI STRIP 1/2

Facility

$4.02

Hospital Charge Code	27060825
Hospital Revenue Code	272
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.01
Rate for Payer: Aetna Commercial	$1.53
Rate for Payer: Aetna Medicare Advantage	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.03
Rate for Payer: Cigna Commercial	$2.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

STERI STRIP 1/2

Facility

$4.02

Hospital Charge Code	27060825
Hospital Revenue Code	272
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

STERI-STRIP 1/2

Facility

$5.00

Hospital Charge Code	270060825
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

STERI-STRIP 1/2

Facility

$5.00

Hospital Charge Code	270060825S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

STERI-STRIP 1/2

Facility

$5.00

Hospital Charge Code	270060825S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

STERI-STRIP 1/2

Facility

$5.00

Hospital Charge Code	270060825N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

STERI-STRIP 1/2

Facility

$5.00

Hospital Charge Code	270060825N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

STERI-STRIP 1/2

Facility

$5.00

Hospital Charge Code	270060825
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

STERI-STRIP 1/4

Facility

$10.45

Hospital Charge Code	270060820
Hospital Revenue Code	272
Min. Negotiated Rate	$1.57
Max. Negotiated Rate	$1.57
Rate for Payer: Qualcare PPO/HMO/WC	$1.57

Know your out-of-pocket cost for care.

All Charges