Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TAMP OAT SZ 6

Facility

$970.00

Hospital Charge Code	270677739
Hospital Revenue Code	272
Min. Negotiated Rate	$27.55
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.20
Rate for Payer: Oxford Commercial	$194.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: UnitedHealthcare Community & State	$30.65
Rate for Payer: Wellpoint Medicaid Managed Care	$27.55

TAMP OAT SZ 6

Facility

$970.00

Hospital Charge Code	270677739
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 7

Facility

$970.00

Hospital Charge Code	270677740
Hospital Revenue Code	272
Min. Negotiated Rate	$27.55
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.20
Rate for Payer: Oxford Commercial	$194.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: UnitedHealthcare Community & State	$30.65
Rate for Payer: Wellpoint Medicaid Managed Care	$27.55

TAMP OAT SZ 7

Facility

$970.00

Hospital Charge Code	270677740
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 8

Facility

$970.00

Hospital Charge Code	270677741
Hospital Revenue Code	272
Min. Negotiated Rate	$27.55
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.20
Rate for Payer: Oxford Commercial	$194.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: UnitedHealthcare Community & State	$30.65
Rate for Payer: Wellpoint Medicaid Managed Care	$27.55

TAMP OAT SZ 8

Facility

$970.00

Hospital Charge Code	270677741
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMP OAT SZ 9

Facility

$970.00

Hospital Charge Code	270677742
Hospital Revenue Code	272
Min. Negotiated Rate	$27.55
Max. Negotiated Rate	$485.00
Rate for Payer: Aetna Commercial	$368.60
Rate for Payer: Aetna Medicare Advantage	$291.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$247.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$247.35
Rate for Payer: Cigna Commercial	$485.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$252.20
Rate for Payer: Oxford Commercial	$194.00
Rate for Payer: Qualcare PPO/HMO/WC	$145.50
Rate for Payer: UnitedHealthcare Commercial	$194.00
Rate for Payer: UnitedHealthcare Community & State	$30.65
Rate for Payer: Wellpoint Medicaid Managed Care	$27.55

TAMP OAT SZ 9

Facility

$970.00

Hospital Charge Code	270677742
Hospital Revenue Code	272
Min. Negotiated Rate	$145.50
Max. Negotiated Rate	$145.50
Rate for Payer: Qualcare PPO/HMO/WC	$145.50

TAMSULOSIN 0.4 MG CAP

Facility

$50.45

Service Code	NDC 597016601
Hospital Charge Code	60628762
Hospital Revenue Code	250
Min. Negotiated Rate	$7.57
Max. Negotiated Rate	$7.57
Rate for Payer: Qualcare PPO/HMO/WC	$7.57

TAMSULOSIN 0.4 MG CAP

Facility

$50.45

Service Code	NDC 597016601
Hospital Charge Code	60628762
Hospital Revenue Code	250
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$25.23
Rate for Payer: Aetna Commercial	$19.17
Rate for Payer: Aetna Medicare Advantage	$15.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.86
Rate for Payer: Cigna Commercial	$25.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.12
Rate for Payer: Oxford Commercial	$10.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.57
Rate for Payer: UnitedHealthcare Commercial	$10.09
Rate for Payer: UnitedHealthcare Community & State	$1.59
Rate for Payer: Wellpoint Medicaid Managed Care	$1.43

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	412311102
Hospital Revenue Code	361
Min. Negotiated Rate	$29.38
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.97
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$155.17
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$32.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$29.38

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	412311102
Hospital Revenue Code	361
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN 1ST LESION

Facility

$9,500.00

Service Code	HCPCS 11102
Hospital Charge Code	404311102
Hospital Revenue Code	361
Min. Negotiated Rate	$269.80
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,470.00
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$300.20
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$269.80

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	395011102
Hospital Revenue Code	761
Min. Negotiated Rate	$29.38
Max. Negotiated Rate	$1,751.90
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.97
Rate for Payer: Oxford Commercial	$206.90
Rate for Payer: Qualcare PPO/HMO/WC	$155.17
Rate for Payer: UnitedHealthcare Commercial	$206.90
Rate for Payer: UnitedHealthcare Community & State	$32.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$29.38

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	395011102
Hospital Revenue Code	761
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	303511102
Hospital Revenue Code	510
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN 1ST LESION

Facility

$9,500.00

Service Code	HCPCS 11102
Hospital Charge Code	404311102
Hospital Revenue Code	361
Min. Negotiated Rate	$1,425.00
Max. Negotiated Rate	$1,425.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,425.00

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	303511102
Hospital Revenue Code	510
Min. Negotiated Rate	$29.38
Max. Negotiated Rate	$1,751.90
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.97
Rate for Payer: Qualcare PPO/HMO/WC	$155.17
Rate for Payer: UnitedHealthcare Community & State	$32.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$29.38

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	450211102
Hospital Revenue Code	761
Min. Negotiated Rate	$155.17
Max. Negotiated Rate	$155.17
Rate for Payer: Qualcare PPO/HMO/WC	$155.17

TANGENTIAL BX SKIN 1ST LESION

Facility

$1,034.49

Service Code	HCPCS 11102
Hospital Charge Code	450211102
Hospital Revenue Code	761
Min. Negotiated Rate	$29.38
Max. Negotiated Rate	$1,751.90
Rate for Payer: Aetna Commercial	$1,313.62
Rate for Payer: Aetna Medicare Advantage	$1,564.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,751.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$482.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$63.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,751.90
Rate for Payer: Cigna Commercial	$968.07
Rate for Payer: Cigna Medicare Advantage	$482.95
Rate for Payer: Clover Medicare Advantage	$458.80
Rate for Payer: EmblemHealth Commercial	$1,448.85
Rate for Payer: Humana Medicare Advantage	$497.44
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$482.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$268.97
Rate for Payer: Oxford Commercial	$206.90
Rate for Payer: Qualcare PPO/HMO/WC	$155.17
Rate for Payer: UnitedHealthcare Commercial	$206.90
Rate for Payer: UnitedHealthcare Community & State	$32.69
Rate for Payer: UnitedHealthcare Medicare Advantage	$482.95
Rate for Payer: Wellcare Medicare Advantage	$482.95
Rate for Payer: Wellpoint Medicaid Managed Care	$29.38

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	395011103
Hospital Revenue Code	761
Min. Negotiated Rate	$14.69
Max. Negotiated Rate	$258.62
Rate for Payer: Aetna Commercial	$196.56
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$34.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$258.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.49
Rate for Payer: Oxford Commercial	$103.45
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Commercial	$103.45
Rate for Payer: UnitedHealthcare Community & State	$16.35
Rate for Payer: Wellpoint Medicaid Managed Care	$14.69

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	412311103
Hospital Revenue Code	361
Min. Negotiated Rate	$14.69
Max. Negotiated Rate	$3,536.00
Rate for Payer: Aetna Commercial	$196.56
Rate for Payer: Aetna Medicare Advantage	$155.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$131.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$131.90
Rate for Payer: Cigna Commercial	$258.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$134.49
Rate for Payer: Oxford Commercial	$2,297.00
Rate for Payer: Qualcare PPO/HMO/WC	$77.59
Rate for Payer: UnitedHealthcare Commercial	$2,256.00
Rate for Payer: UnitedHealthcare Community & State	$16.35
Rate for Payer: Wellpoint Medicaid Managed Care	$14.69

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	412311103
Hospital Revenue Code	361
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	395011103
Hospital Revenue Code	761
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

TANGENTIAL BX SKIN EA ADD LES

Facility

$517.25

Service Code	HCPCS 11103
Hospital Charge Code	450211103
Hospital Revenue Code	761
Min. Negotiated Rate	$77.59
Max. Negotiated Rate	$77.59
Rate for Payer: Qualcare PPO/HMO/WC	$77.59

Know your out-of-pocket cost for care.

All Charges