Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TEFLON COATED GUIDE WIRE

Facility

$115.00

Hospital Charge Code	270330509
Hospital Revenue Code	278
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$27.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.83
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

TEFLON COATED GUIDE WIRE

Facility

$115.00

Hospital Charge Code	270330509
Hospital Revenue Code	278
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$57.50
Rate for Payer: Aetna Commercial	$43.70
Rate for Payer: Aetna Medicare Advantage	$34.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$23.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$27.83
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.27

TEFLON COATED STR. WIRE GUIDE

Facility

$211.00

Hospital Charge Code	270331705
Hospital Revenue Code	272
Min. Negotiated Rate	$5.99
Max. Negotiated Rate	$105.50
Rate for Payer: Aetna Commercial	$80.18
Rate for Payer: Aetna Medicare Advantage	$63.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.80
Rate for Payer: Cigna Commercial	$105.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$54.86
Rate for Payer: Oxford Commercial	$42.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.65
Rate for Payer: UnitedHealthcare Commercial	$42.20
Rate for Payer: UnitedHealthcare Community & State	$6.67
Rate for Payer: Wellpoint Medicaid Managed Care	$5.99

TEFLON COATED STR. WIRE GUIDE

Facility

$211.00

Hospital Charge Code	270331705
Hospital Revenue Code	272
Min. Negotiated Rate	$31.65
Max. Negotiated Rate	$31.65
Rate for Payer: Qualcare PPO/HMO/WC	$31.65

TEGADERM 4 X 4 3/4

Facility

$125.50

Hospital Charge Code	270655053
Hospital Revenue Code	270
Min. Negotiated Rate	$3.56
Max. Negotiated Rate	$62.75
Rate for Payer: Aetna Commercial	$47.69
Rate for Payer: Aetna Medicare Advantage	$37.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.00
Rate for Payer: Cigna Commercial	$62.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.63
Rate for Payer: Oxford Commercial	$25.10
Rate for Payer: Qualcare PPO/HMO/WC	$18.82
Rate for Payer: UnitedHealthcare Commercial	$25.10
Rate for Payer: UnitedHealthcare Community & State	$3.97
Rate for Payer: Wellpoint Medicaid Managed Care	$3.56

TEGADERM 4 X 4 3/4

Facility

$125.50

Hospital Charge Code	270655053
Hospital Revenue Code	270
Min. Negotiated Rate	$18.82
Max. Negotiated Rate	$18.82
Rate for Payer: Qualcare PPO/HMO/WC	$18.82

TEGADERM FILM 3M 8X12

Facility

$8.89

Hospital Charge Code	270655592
Hospital Revenue Code	270
Min. Negotiated Rate	$0.25
Max. Negotiated Rate	$4.45
Rate for Payer: Aetna Commercial	$3.38
Rate for Payer: Aetna Medicare Advantage	$2.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.27
Rate for Payer: Cigna Commercial	$4.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.31
Rate for Payer: Oxford Commercial	$1.78
Rate for Payer: Qualcare PPO/HMO/WC	$1.33
Rate for Payer: UnitedHealthcare Commercial	$1.78
Rate for Payer: UnitedHealthcare Community & State	$0.28
Rate for Payer: Wellpoint Medicaid Managed Care	$0.25

TEGADERM FILM 3M 8X12

Facility

$8.89

Hospital Charge Code	270655592
Hospital Revenue Code	270
Min. Negotiated Rate	$1.33
Max. Negotiated Rate	$1.33
Rate for Payer: Qualcare PPO/HMO/WC	$1.33

TEGADERM OCCLUSIVE 4 X 6

Facility

$125.05

Hospital Charge Code	270649961
Hospital Revenue Code	272
Min. Negotiated Rate	$3.55
Max. Negotiated Rate	$62.52
Rate for Payer: Aetna Commercial	$47.52
Rate for Payer: Aetna Medicare Advantage	$37.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.89
Rate for Payer: Cigna Commercial	$62.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.51
Rate for Payer: Oxford Commercial	$25.01
Rate for Payer: Qualcare PPO/HMO/WC	$18.76
Rate for Payer: UnitedHealthcare Commercial	$25.01
Rate for Payer: UnitedHealthcare Community & State	$3.95
Rate for Payer: Wellpoint Medicaid Managed Care	$3.55

TEGADERM OCCLUSIVE 4 X 6

Facility

$125.05

Hospital Charge Code	270649961
Hospital Revenue Code	272
Min. Negotiated Rate	$18.76
Max. Negotiated Rate	$18.76
Rate for Payer: Qualcare PPO/HMO/WC	$18.76

TEGADERM TRANSP 6X8

Facility

$6.04

Hospital Charge Code	270650240S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.91
Max. Negotiated Rate	$0.91
Rate for Payer: Qualcare PPO/HMO/WC	$0.91

TEGADERM TRANSP 6X8

Facility

$6.04

Hospital Charge Code	270650240S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$3.02
Rate for Payer: Aetna Commercial	$2.30
Rate for Payer: Aetna Medicare Advantage	$1.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.54
Rate for Payer: Cigna Commercial	$3.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.57
Rate for Payer: Oxford Commercial	$1.21
Rate for Payer: Qualcare PPO/HMO/WC	$0.91
Rate for Payer: UnitedHealthcare Commercial	$1.21
Rate for Payer: UnitedHealthcare Community & State	$0.19
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

TEGADERM TRANSPAREMT 4X4 1626W

Facility

$3.09

Hospital Charge Code	270649122
Hospital Revenue Code	270
Min. Negotiated Rate	$0.09
Max. Negotiated Rate	$1.54
Rate for Payer: Aetna Commercial	$1.17
Rate for Payer: Aetna Medicare Advantage	$0.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.79
Rate for Payer: Cigna Commercial	$1.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.80
Rate for Payer: Oxford Commercial	$0.62
Rate for Payer: Qualcare PPO/HMO/WC	$0.46
Rate for Payer: UnitedHealthcare Commercial	$0.62
Rate for Payer: UnitedHealthcare Community & State	$0.10
Rate for Payer: Wellpoint Medicaid Managed Care	$0.09

TEGADERM TRANSPAREMT 4X4 1626W

Facility

$3.09

Hospital Charge Code	270649122
Hospital Revenue Code	270
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.46
Rate for Payer: Qualcare PPO/HMO/WC	$0.46

TEGADERM TRANSPARENT 8X12

Facility

$9.75

Hospital Charge Code	270649123
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.46

TEGADERM TRANSPARENT 8X12

Facility

$9.75

Hospital Charge Code	270649123
Hospital Revenue Code	272
Min. Negotiated Rate	$0.28
Max. Negotiated Rate	$4.88
Rate for Payer: Aetna Commercial	$3.71
Rate for Payer: Aetna Medicare Advantage	$2.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.49
Rate for Payer: Cigna Commercial	$4.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.54
Rate for Payer: Oxford Commercial	$1.95
Rate for Payer: Qualcare PPO/HMO/WC	$1.46
Rate for Payer: UnitedHealthcare Commercial	$1.95
Rate for Payer: UnitedHealthcare Community & State	$0.31
Rate for Payer: Wellpoint Medicaid Managed Care	$0.28

TEGASORB 4 X 4 3/4

Facility

$44.85

Hospital Charge Code	270350218
Hospital Revenue Code	272
Min. Negotiated Rate	$1.27
Max. Negotiated Rate	$22.43
Rate for Payer: Aetna Commercial	$17.04
Rate for Payer: Aetna Medicare Advantage	$13.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.44
Rate for Payer: Cigna Commercial	$22.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.66
Rate for Payer: Oxford Commercial	$8.97
Rate for Payer: Qualcare PPO/HMO/WC	$6.73
Rate for Payer: UnitedHealthcare Commercial	$8.97
Rate for Payer: UnitedHealthcare Community & State	$1.42
Rate for Payer: Wellpoint Medicaid Managed Care	$1.27

TEGASORB 4 X 4 3/4

Facility

$44.85

Hospital Charge Code	270350218
Hospital Revenue Code	272
Min. Negotiated Rate	$6.73
Max. Negotiated Rate	$6.73
Rate for Payer: Qualcare PPO/HMO/WC	$6.73

TEGRETOL CITRUS-VANILLA

Facility

$4.00

Service Code	NDC 60432012916
Hospital Charge Code	60633976
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
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

TEGRETOL CITRUS-VANILLA

Facility

$4.00

Service Code	NDC 60432012916
Hospital Charge Code	60633976
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

TEGRETOL XR 100 BULK

Facility

$7.44

Service Code	NDC 78051005
Hospital Charge Code	60635257
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$3.72
Rate for Payer: Aetna Commercial	$2.83
Rate for Payer: Aetna Medicare Advantage	$2.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.90
Rate for Payer: Cigna Commercial	$3.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.93
Rate for Payer: Oxford Commercial	$1.49
Rate for Payer: Qualcare PPO/HMO/WC	$1.12
Rate for Payer: UnitedHealthcare Commercial	$1.49
Rate for Payer: UnitedHealthcare Community & State	$0.24
Rate for Payer: Wellpoint Medicaid Managed Care	$0.21

TEGRETOL XR 100 BULK

Facility

$7.44

Service Code	NDC 78051005
Hospital Charge Code	60635257
Hospital Revenue Code	250
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$1.12
Rate for Payer: Qualcare PPO/HMO/WC	$1.12

TEGRETOL XR 200 U/D

Facility

$13.94

Service Code	NDC 51672412401
Hospital Charge Code	60635258
Hospital Revenue Code	250
Min. Negotiated Rate	$0.40
Max. Negotiated Rate	$6.97
Rate for Payer: Aetna Commercial	$5.30
Rate for Payer: Aetna Medicare Advantage	$4.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.55
Rate for Payer: Cigna Commercial	$6.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.62
Rate for Payer: Oxford Commercial	$2.79
Rate for Payer: Qualcare PPO/HMO/WC	$2.09
Rate for Payer: UnitedHealthcare Commercial	$2.79
Rate for Payer: UnitedHealthcare Community & State	$0.44
Rate for Payer: Wellpoint Medicaid Managed Care	$0.40

TEGRETOL XR 200 U/D

Facility

$13.94

Service Code	NDC 51672412401
Hospital Charge Code	60635258
Hospital Revenue Code	250
Min. Negotiated Rate	$2.09
Max. Negotiated Rate	$2.09
Rate for Payer: Qualcare PPO/HMO/WC	$2.09

TEICHOIC ACID AB

Facility

$82.35

Service Code	HCPCS 86331
Hospital Charge Code	39900213
Hospital Revenue Code	302
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$32.59
Rate for Payer: Aetna Medicare Advantage	$38.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$11.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$7.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.46
Rate for Payer: Cigna Commercial	$41.17
Rate for Payer: Cigna Medicare Advantage	$11.98
Rate for Payer: Clover Medicare Advantage	$11.38
Rate for Payer: EmblemHealth Commercial	$35.94
Rate for Payer: Humana Medicare Advantage	$12.34
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$11.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.41
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$12.35
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$9.58
Rate for Payer: UnitedHealthcare Medicare Advantage	$11.98
Rate for Payer: Wellcare Medicare Advantage	$11.98
Rate for Payer: Wellpoint Medicaid Managed Care	$2.34

Know your out-of-pocket cost for care.

All Charges