Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

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

$14.25

Hospital Charge Code	270658527
Hospital Revenue Code	272
Min. Negotiated Rate	$2.14
Max. Negotiated Rate	$2.14
Rate for Payer: Qualcare PPO/HMO/WC	$2.14

BANDAGE PLASTER 2X 3 YRD

Facility

$124.85

Hospital Charge Code	270609828
Hospital Revenue Code	272
Min. Negotiated Rate	$18.73
Max. Negotiated Rate	$18.73
Rate for Payer: Qualcare PPO/HMO/WC	$18.73

BANDAGE PLASTER 2X 3 YRD

Facility

$124.85

Hospital Charge Code	270609828
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$62.42
Rate for Payer: Aetna Commercial	$47.44
Rate for Payer: Aetna Medicare Advantage	$37.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.84
Rate for Payer: Cigna Commercial	$62.42
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.46
Rate for Payer: Oxford Commercial	$24.97
Rate for Payer: Qualcare PPO/HMO/WC	$18.73
Rate for Payer: UnitedHealthcare Commercial	$24.97
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

BANDAGE PLASTER 3

Facility

$4.72

Hospital Charge Code	27060035
Hospital Revenue Code	270
Min. Negotiated Rate	$0.13
Max. Negotiated Rate	$2.36
Rate for Payer: Aetna Commercial	$1.79
Rate for Payer: Aetna Medicare Advantage	$1.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.20
Rate for Payer: Cigna Commercial	$2.36
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.23
Rate for Payer: Oxford Commercial	$0.94
Rate for Payer: Qualcare PPO/HMO/WC	$0.71
Rate for Payer: UnitedHealthcare Commercial	$0.94
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.13

BANDAGE PLASTER 3

Facility

$13.65

Hospital Charge Code	270060035
Hospital Revenue Code	272
Min. Negotiated Rate	$0.39
Max. Negotiated Rate	$6.83
Rate for Payer: Aetna Commercial	$5.19
Rate for Payer: Aetna Medicare Advantage	$4.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.48
Rate for Payer: Cigna Commercial	$6.83
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.55
Rate for Payer: Oxford Commercial	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.05
Rate for Payer: UnitedHealthcare Commercial	$2.73
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.39

BANDAGE PLASTER 3

Facility

$4.72

Hospital Charge Code	27060035
Hospital Revenue Code	270
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$0.71
Rate for Payer: Qualcare PPO/HMO/WC	$0.71

BANDAGE PLASTER 3

Facility

$13.65

Hospital Charge Code	270060035
Hospital Revenue Code	272
Min. Negotiated Rate	$2.05
Max. Negotiated Rate	$2.05
Rate for Payer: Qualcare PPO/HMO/WC	$2.05

BANDAGE PLASTER 4

Facility

$6.88

Hospital Charge Code	27060040
Hospital Revenue Code	270
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.44
Rate for Payer: Aetna Commercial	$2.61
Rate for Payer: Aetna Medicare Advantage	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.75
Rate for Payer: Cigna Commercial	$3.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.79
Rate for Payer: Oxford Commercial	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$1.38
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

BANDAGE PLASTER 4

Facility

$6.88

Hospital Charge Code	27060040
Hospital Revenue Code	270
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.03

BANDAGE PLASTER 4 IN

Facility

$7.56

Hospital Charge Code	270060040
Hospital Revenue Code	272
Min. Negotiated Rate	$1.13
Max. Negotiated Rate	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$1.13

BANDAGE PLASTER 4 IN

Facility

$7.56

Hospital Charge Code	270060040
Hospital Revenue Code	272
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.78
Rate for Payer: Aetna Commercial	$2.87
Rate for Payer: Aetna Medicare Advantage	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.93
Rate for Payer: Cigna Commercial	$3.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.97
Rate for Payer: Oxford Commercial	$1.51
Rate for Payer: Qualcare PPO/HMO/WC	$1.13
Rate for Payer: UnitedHealthcare Commercial	$1.51
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

BANDAGE PLASTER 6

Facility

$9.21

Hospital Charge Code	270060045
Hospital Revenue Code	272
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$4.61
Rate for Payer: Aetna Commercial	$3.50
Rate for Payer: Aetna Medicare Advantage	$2.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.35
Rate for Payer: Cigna Commercial	$4.61
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.39
Rate for Payer: Oxford Commercial	$1.84
Rate for Payer: Qualcare PPO/HMO/WC	$1.38
Rate for Payer: UnitedHealthcare Commercial	$1.84
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

BANDAGE PLASTER 6

Facility

$8.61

Hospital Charge Code	27060045
Hospital Revenue Code	270
Min. Negotiated Rate	$0.24
Max. Negotiated Rate	$4.30
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.20
Rate for Payer: Cigna Commercial	$4.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.24
Rate for Payer: Oxford Commercial	$1.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Commercial	$1.72
Rate for Payer: UnitedHealthcare Community & State	$0.27
Rate for Payer: Wellpoint Medicaid Managed Care	$0.24

BANDAGE PLASTER 6

Facility

$9.21

Hospital Charge Code	270060045
Hospital Revenue Code	272
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.38

BANDAGE PLASTER 6

Facility

$8.61

Hospital Charge Code	27060045
Hospital Revenue Code	270
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

BANDAGE PLASTER FST SET 3X 3Y

Facility

$36.00

Hospital Charge Code	270331863
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$13.68
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.36
Rate for Payer: Oxford Commercial	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$7.20
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.02

BANDAGE PLASTER FST SET 3X 3Y

Facility

$36.00

Hospital Charge Code	270331863
Hospital Revenue Code	272
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

BANDAGE PLASTER FST SET 5 X 5

Facility

$62.00

Hospital Charge Code	270331278
Hospital Revenue Code	272
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$31.00
Rate for Payer: Aetna Commercial	$23.56
Rate for Payer: Aetna Medicare Advantage	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.81
Rate for Payer: Cigna Commercial	$31.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.12
Rate for Payer: Oxford Commercial	$12.40
Rate for Payer: Qualcare PPO/HMO/WC	$9.30
Rate for Payer: UnitedHealthcare Commercial	$12.40
Rate for Payer: UnitedHealthcare Community & State	$1.96
Rate for Payer: Wellpoint Medicaid Managed Care	$1.76

BANDAGE PLASTER FST SET 5 X 5

Facility

$62.00

Hospital Charge Code	270331278
Hospital Revenue Code	272
Min. Negotiated Rate	$9.30
Max. Negotiated Rate	$9.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.30

BANDAGE PLASTER OF PARIS 45YD

Facility

$30.00

Hospital Charge Code	270330849
Hospital Revenue Code	270
Min. Negotiated Rate	$4.50
Max. Negotiated Rate	$4.50
Rate for Payer: Qualcare PPO/HMO/WC	$4.50

BANDAGE PLASTER OF PARIS 45YD

Facility

$30.00

Hospital Charge Code	270330849
Hospital Revenue Code	270
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$15.00
Rate for Payer: Aetna Commercial	$11.40
Rate for Payer: Aetna Medicare Advantage	$9.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.65
Rate for Payer: Cigna Commercial	$15.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.80
Rate for Payer: Oxford Commercial	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$4.50
Rate for Payer: UnitedHealthcare Commercial	$6.00
Rate for Payer: UnitedHealthcare Community & State	$0.95
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

BANDAGE PLASTER X-FAST 2

Facility

$4.05

Hospital Charge Code	270649479
Hospital Revenue Code	272
Min. Negotiated Rate	$0.12
Max. Negotiated Rate	$2.02
Rate for Payer: Aetna Commercial	$1.54
Rate for Payer: Aetna Medicare Advantage	$1.22
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	$2.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.05
Rate for Payer: Oxford Commercial	$0.81
Rate for Payer: Qualcare PPO/HMO/WC	$0.61
Rate for Payer: UnitedHealthcare Commercial	$0.81
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.12

BANDAGE PLASTER X-FAST 2

Facility

$4.05

Hospital Charge Code	270649479
Hospital Revenue Code	272
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$0.61
Rate for Payer: Qualcare PPO/HMO/WC	$0.61

BANDAGE PLASTER X-FAST 3

Facility

$5.47

Hospital Charge Code	270649480
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$0.82
Rate for Payer: Qualcare PPO/HMO/WC	$0.82

Know your out-of-pocket cost for care.

All Charges