Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BANDAGE PLASTER X-FAST 3

Facility

$5.47

Hospital Charge Code	270649480
Hospital Revenue Code	272
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.73
Rate for Payer: Aetna Commercial	$2.08
Rate for Payer: Aetna Medicare Advantage	$1.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.39
Rate for Payer: Cigna Commercial	$2.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.42
Rate for Payer: Oxford Commercial	$1.09
Rate for Payer: Qualcare PPO/HMO/WC	$0.82
Rate for Payer: UnitedHealthcare Commercial	$1.09
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

BANDAGE PLASTER X-FAST 6

Facility

$9.32

Hospital Charge Code	270649482
Hospital Revenue Code	272
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$4.66
Rate for Payer: Aetna Commercial	$3.54
Rate for Payer: Aetna Medicare Advantage	$2.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.38
Rate for Payer: Cigna Commercial	$4.66
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.42
Rate for Payer: Oxford Commercial	$1.86
Rate for Payer: Qualcare PPO/HMO/WC	$1.40
Rate for Payer: UnitedHealthcare Commercial	$1.86
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

BANDAGE PLASTER X-FAST 6

Facility

$9.32

Hospital Charge Code	270649482
Hospital Revenue Code	272
Min. Negotiated Rate	$1.40
Max. Negotiated Rate	$1.40
Rate for Payer: Qualcare PPO/HMO/WC	$1.40

BANDAGE SHURLOCK W/VELCRO

Facility

$4.77

Hospital Charge Code	270653855
Hospital Revenue Code	272
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$0.72
Rate for Payer: Qualcare PPO/HMO/WC	$0.72

BANDAGE SHURLOCK W/VELCRO

Facility

$4.77

Hospital Charge Code	270653855
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.38
Rate for Payer: Aetna Commercial	$1.81
Rate for Payer: Aetna Medicare Advantage	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.22
Rate for Payer: Cigna Commercial	$2.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.24
Rate for Payer: Oxford Commercial	$0.95
Rate for Payer: Qualcare PPO/HMO/WC	$0.72
Rate for Payer: UnitedHealthcare Commercial	$0.95
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

BANDAGE SPANDAGE SZ.2 10YD

Facility

$60.00

Hospital Charge Code	270331100
Hospital Revenue Code	272
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$9.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00

BANDAGE SPANDAGE SZ.2 10YD

Facility

$60.00

Hospital Charge Code	270331100
Hospital Revenue Code	272
Min. Negotiated Rate	$1.70
Max. Negotiated Rate	$30.00
Rate for Payer: Aetna Commercial	$22.80
Rate for Payer: Aetna Medicare Advantage	$18.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.30
Rate for Payer: Cigna Commercial	$30.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.60
Rate for Payer: Oxford Commercial	$12.00
Rate for Payer: Qualcare PPO/HMO/WC	$9.00
Rate for Payer: UnitedHealthcare Commercial	$12.00
Rate for Payer: UnitedHealthcare Community & State	$1.90
Rate for Payer: Wellpoint Medicaid Managed Care	$1.70

BANDAGE SPANDAGE SZ. 4 10YD

Facility

$15.00

Hospital Charge Code	270331259
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

BANDAGE SPANDAGE SZ. 4 10YD

Facility

$15.00

Hospital Charge Code	270331259
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

BANDAGE SYS PROFORE 4-LAYER

Facility

$61.98

Hospital Charge Code	270650138
Hospital Revenue Code	270
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$30.99
Rate for Payer: Aetna Commercial	$23.55
Rate for Payer: Aetna Medicare Advantage	$18.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$15.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$15.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$15.80
Rate for Payer: Cigna Commercial	$30.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.11
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 SYS PROFORE 4-LAYER

Facility

$61.98

Hospital Charge Code	270650138
Hospital Revenue Code	270
Min. Negotiated Rate	$9.30
Max. Negotiated Rate	$9.30
Rate for Payer: Qualcare PPO/HMO/WC	$9.30

BANDAGE THERMAL LATEX FREE 7IN

Facility

$9.22

Hospital Charge Code	270654003
Hospital Revenue Code	270
Min. Negotiated Rate	$1.38
Max. Negotiated Rate	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.38

BANDAGE THERMAL LATEX FREE 7IN

Facility

$9.22

Hospital Charge Code	270654003
Hospital Revenue Code	270
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$4.61
Rate for Payer: Aetna Commercial	$3.50
Rate for Payer: Aetna Medicare Advantage	$2.77
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	$2.40
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 UNNA BOOT 4

Facility

$27.23

Hospital Charge Code	270649893
Hospital Revenue Code	272
Min. Negotiated Rate	$4.08
Max. Negotiated Rate	$4.08
Rate for Payer: Qualcare PPO/HMO/WC	$4.08

BANDAGE UNNA BOOT 4

Facility

$27.23

Hospital Charge Code	270649893
Hospital Revenue Code	272
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$13.62
Rate for Payer: Aetna Commercial	$10.35
Rate for Payer: Aetna Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.94
Rate for Payer: Cigna Commercial	$13.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.08
Rate for Payer: Oxford Commercial	$5.45
Rate for Payer: Qualcare PPO/HMO/WC	$4.08
Rate for Payer: UnitedHealthcare Commercial	$5.45
Rate for Payer: UnitedHealthcare Community & State	$0.86
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

BAND EXERCISE LEVEL 3 4in. 50y

Facility

$575.00

Hospital Charge Code	270665145
Hospital Revenue Code	270
Min. Negotiated Rate	$86.25
Max. Negotiated Rate	$86.25
Rate for Payer: Qualcare PPO/HMO/WC	$86.25

BAND EXERCISE LEVEL 3 4in. 50y

Facility

$575.00

Hospital Charge Code	270665145
Hospital Revenue Code	270
Min. Negotiated Rate	$16.33
Max. Negotiated Rate	$287.50
Rate for Payer: Aetna Commercial	$218.50
Rate for Payer: Aetna Medicare Advantage	$172.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$146.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$146.62
Rate for Payer: Cigna Commercial	$287.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$149.50
Rate for Payer: Oxford Commercial	$115.00
Rate for Payer: Qualcare PPO/HMO/WC	$86.25
Rate for Payer: UnitedHealthcare Commercial	$115.00
Rate for Payer: UnitedHealthcare Community & State	$18.17
Rate for Payer: Wellpoint Medicaid Managed Care	$16.33

BAND GASTRIC ADJUSTABLE

Facility

$13,600.00

Hospital Charge Code	270676279
Hospital Revenue Code	278
Min. Negotiated Rate	$2,040.00
Max. Negotiated Rate	$3,291.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,720.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,291.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,040.00

BAND GASTRIC ADJUSTABLE

Facility

$13,600.00

Hospital Charge Code	270676279
Hospital Revenue Code	278
Min. Negotiated Rate	$386.24
Max. Negotiated Rate	$6,800.00
Rate for Payer: Aetna Commercial	$5,168.00
Rate for Payer: Aetna Medicare Advantage	$4,080.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,468.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,720.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,468.00
Rate for Payer: Cigna Commercial	$6,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,291.20
Rate for Payer: Qualcare PPO/HMO/WC	$2,040.00
Rate for Payer: UnitedHealthcare Community & State	$429.76
Rate for Payer: Wellpoint Medicaid Managed Care	$386.24

BAND LIGATOR-6 SHOOTER SAEED M

Facility

$521.00

Hospital Charge Code	270334801
Hospital Revenue Code	272
Min. Negotiated Rate	$14.80
Max. Negotiated Rate	$260.50
Rate for Payer: Aetna Commercial	$197.98
Rate for Payer: Aetna Medicare Advantage	$156.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$132.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$132.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$132.85
Rate for Payer: Cigna Commercial	$260.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$135.46
Rate for Payer: Oxford Commercial	$104.20
Rate for Payer: Qualcare PPO/HMO/WC	$78.15
Rate for Payer: UnitedHealthcare Commercial	$104.20
Rate for Payer: UnitedHealthcare Community & State	$16.46
Rate for Payer: Wellpoint Medicaid Managed Care	$14.80

BAND LIGATOR-6 SHOOTER SAEED M

Facility

$521.00

Hospital Charge Code	270334801
Hospital Revenue Code	272
Min. Negotiated Rate	$78.15
Max. Negotiated Rate	$78.15
Rate for Payer: Qualcare PPO/HMO/WC	$78.15

BAND SET STRUT MAXFRAME SET

Facility

$2,250.00

Hospital Charge Code	270683952
Hospital Revenue Code	272
Min. Negotiated Rate	$337.50
Max. Negotiated Rate	$337.50
Rate for Payer: Qualcare PPO/HMO/WC	$337.50

BAND SET STRUT MAXFRAME SET

Facility

$2,250.00

Hospital Charge Code	270683952
Hospital Revenue Code	272
Min. Negotiated Rate	$63.90
Max. Negotiated Rate	$1,125.00
Rate for Payer: Aetna Commercial	$855.00
Rate for Payer: Aetna Medicare Advantage	$675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$573.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$573.75
Rate for Payer: Cigna Commercial	$1,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$585.00
Rate for Payer: Oxford Commercial	$450.00
Rate for Payer: Qualcare PPO/HMO/WC	$337.50
Rate for Payer: UnitedHealthcare Commercial	$450.00
Rate for Payer: UnitedHealthcare Community & State	$71.10
Rate for Payer: Wellpoint Medicaid Managed Care	$63.90

BARBITURATE SCREEN AND CONFIRM

Facility

$190.45

Service Code	HCPCS 80345
Hospital Charge Code	3038101
Hospital Revenue Code	301
Min. Negotiated Rate	$5.41
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$72.37
Rate for Payer: Aetna Medicare Advantage	$57.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$48.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$48.56
Rate for Payer: Cigna Commercial	$95.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$49.52
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$28.57
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$5.41

BARBITURATE SCREEN AND CONFIRM

Facility

$190.45

Service Code	HCPCS 80345
Hospital Charge Code	3038101
Hospital Revenue Code	301
Min. Negotiated Rate	$28.57
Max. Negotiated Rate	$28.57
Rate for Payer: Qualcare PPO/HMO/WC	$28.57

Know your out-of-pocket cost for care.

All Charges