Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TENDRIL LEADS U PR 58

Facility

$4,515.00

Service Code	HCPCS C1898
Hospital Charge Code	270669000N
Hospital Revenue Code	278
Min. Negotiated Rate	$128.23
Max. Negotiated Rate	$2,257.50
Rate for Payer: Aetna Commercial	$1,715.70
Rate for Payer: Aetna Medicare Advantage	$1,354.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,151.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,151.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$903.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,151.33
Rate for Payer: Cigna Commercial	$2,257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,092.63
Rate for Payer: Qualcare PPO/HMO/WC	$677.25
Rate for Payer: UnitedHealthcare Community & State	$142.67
Rate for Payer: Wellpoint Medicaid Managed Care	$128.23

TENDRIL LEADS U PR 58

Facility

$4,515.00

Service Code	HCPCS C1898
Hospital Charge Code	270669000N
Hospital Revenue Code	278
Min. Negotiated Rate	$677.25
Max. Negotiated Rate	$1,092.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$903.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,092.63
Rate for Payer: Qualcare PPO/HMO/WC	$677.25

TENDRIL LEADS U PR 58

Facility

$4,515.00

Service Code	HCPCS C1898
Hospital Charge Code	270669000S
Hospital Revenue Code	278
Min. Negotiated Rate	$128.23
Max. Negotiated Rate	$2,257.50
Rate for Payer: Aetna Commercial	$1,715.70
Rate for Payer: Aetna Medicare Advantage	$1,354.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,151.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,151.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$903.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,151.33
Rate for Payer: Cigna Commercial	$2,257.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,092.63
Rate for Payer: Qualcare PPO/HMO/WC	$677.25
Rate for Payer: UnitedHealthcare Community & State	$142.67
Rate for Payer: Wellpoint Medicaid Managed Care	$128.23

Tenecteplase 50mg inj

Facility

$28,404.46

Hospital Charge Code	606361032
Hospital Revenue Code	636
Min. Negotiated Rate	$4,260.67
Max. Negotiated Rate	$6,873.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,873.88
Rate for Payer: Qualcare PPO/HMO/WC	$4,260.67

Tenecteplase 50mg inj

Facility

$28,404.46

Hospital Charge Code	606361032
Hospital Revenue Code	636
Min. Negotiated Rate	$806.69
Max. Negotiated Rate	$14,202.23
Rate for Payer: Aetna Commercial	$10,793.69
Rate for Payer: Aetna Medicare Advantage	$8,521.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,243.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,243.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,243.14
Rate for Payer: Cigna Commercial	$14,202.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6,873.88
Rate for Payer: Qualcare PPO/HMO/WC	$4,260.67
Rate for Payer: UnitedHealthcare Community & State	$897.58
Rate for Payer: Wellpoint Medicaid Managed Care	$806.69

TENIVAC 0.5ML PREFILLED SYRING

Facility

$192.76

Service Code	HCPCS 90714
Hospital Charge Code	606350971
Hospital Revenue Code	636
Min. Negotiated Rate	$5.47
Max. Negotiated Rate	$96.38
Rate for Payer: Aetna Commercial	$73.25
Rate for Payer: Aetna Medicare Advantage	$57.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.15
Rate for Payer: Cigna Commercial	$96.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$28.91
Rate for Payer: UnitedHealthcare Community & State	$6.09
Rate for Payer: Wellpoint Medicaid Managed Care	$5.47

TENIVAC 0.5ML PREFILLED SYRING

Facility

$192.76

Service Code	HCPCS 90714
Hospital Charge Code	606350971
Hospital Revenue Code	636
Min. Negotiated Rate	$28.91
Max. Negotiated Rate	$46.65
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$46.65
Rate for Payer: Qualcare PPO/HMO/WC	$28.91

TENIVAC EX

Facility

$192.76

Service Code	NDC 49281021515
Hospital Charge Code	606350971X
Hospital Revenue Code	259
Min. Negotiated Rate	$28.91
Max. Negotiated Rate	$28.91
Rate for Payer: Qualcare PPO/HMO/WC	$28.91

TENIVAC EX

Facility

$192.76

Service Code	NDC 49281021515
Hospital Charge Code	606350971X
Hospital Revenue Code	259
Min. Negotiated Rate	$5.47
Max. Negotiated Rate	$96.38
Rate for Payer: Aetna Commercial	$73.25
Rate for Payer: Aetna Medicare Advantage	$57.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$49.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$49.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$49.15
Rate for Payer: Cigna Commercial	$96.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.12
Rate for Payer: Oxford Commercial	$38.55
Rate for Payer: Qualcare PPO/HMO/WC	$28.91
Rate for Payer: UnitedHealthcare Commercial	$38.55
Rate for Payer: UnitedHealthcare Community & State	$6.09
Rate for Payer: Wellpoint Medicaid Managed Care	$5.47

TENJET PERCUTANOUS SYSTEM

Facility

$4,250.00

Hospital Charge Code	270691836
Hospital Revenue Code	272
Min. Negotiated Rate	$120.70
Max. Negotiated Rate	$2,125.00
Rate for Payer: Aetna Commercial	$1,615.00
Rate for Payer: Aetna Medicare Advantage	$1,275.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,083.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,083.75
Rate for Payer: Cigna Commercial	$2,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,105.00
Rate for Payer: Oxford Commercial	$850.00
Rate for Payer: Qualcare PPO/HMO/WC	$637.50
Rate for Payer: UnitedHealthcare Commercial	$850.00
Rate for Payer: UnitedHealthcare Community & State	$134.30
Rate for Payer: Wellpoint Medicaid Managed Care	$120.70

TENJET PERCUTANOUS SYSTEM

Facility

$4,250.00

Hospital Charge Code	270691836
Hospital Revenue Code	272
Min. Negotiated Rate	$637.50
Max. Negotiated Rate	$637.50
Rate for Payer: Qualcare PPO/HMO/WC	$637.50

TENLYSIS FL/EX TEND FA/W EA TN

Facility

$19,467.90

Service Code	HCPCS 25295
Hospital Charge Code	16000505
Hospital Revenue Code	360
Min. Negotiated Rate	$552.89
Max. Negotiated Rate	$14,100.89
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
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	$14,100.89
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,061.65
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$615.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$552.89

TENLYSIS FL/EX TEND FA/W EA TN

Facility

$19,467.90

Service Code	HCPCS 25295
Hospital Charge Code	16000505
Hospital Revenue Code	360
Min. Negotiated Rate	$2,920.18
Max. Negotiated Rate	$2,920.18
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18

TENODESIS GRAFT SIZING KIT

Facility

$1,475.00

Hospital Charge Code	270694886
Hospital Revenue Code	279
Min. Negotiated Rate	$41.89
Max. Negotiated Rate	$737.50
Rate for Payer: Aetna Commercial	$560.50
Rate for Payer: Aetna Medicare Advantage	$442.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$376.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$376.12
Rate for Payer: Cigna Commercial	$737.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$383.50
Rate for Payer: Oxford Commercial	$295.00
Rate for Payer: Qualcare PPO/HMO/WC	$221.25
Rate for Payer: UnitedHealthcare Commercial	$295.00
Rate for Payer: UnitedHealthcare Community & State	$46.61
Rate for Payer: Wellpoint Medicaid Managed Care	$41.89

TENODESIS GRAFT SIZING KIT

Facility

$1,475.00

Hospital Charge Code	270694886
Hospital Revenue Code	279
Min. Negotiated Rate	$221.25
Max. Negotiated Rate	$221.25
Rate for Payer: Qualcare PPO/HMO/WC	$221.25

TENODESIS LG TENDON BICEPTSLT

Facility

$44,916.00

Service Code	HCPCS 23430
Hospital Charge Code	16000324
Hospital Revenue Code	360
Min. Negotiated Rate	$6,737.40
Max. Negotiated Rate	$6,737.40
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40

TENODESIS LG TENDON BICEPTSLT

Facility

$44,916.00

Service Code	HCPCS 23430
Hospital Charge Code	16000324
Hospital Revenue Code	360
Min. Negotiated Rate	$1,275.61
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,678.16
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,419.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,275.61

TENODESIS OF BICEPS TNDNAT EL

Facility

$44,916.00

Service Code	HCPCS 24340
Hospital Charge Code	16000614
Hospital Revenue Code	360
Min. Negotiated Rate	$1,275.61
Max. Negotiated Rate	$31,271.12
Rate for Payer: Aetna Commercial	$23,447.95
Rate for Payer: Aetna Medicare Advantage	$27,930.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31,271.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8,620.57
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	$31,271.12
Rate for Payer: Cigna Commercial	$17,279.91
Rate for Payer: Cigna Medicare Advantage	$8,620.57
Rate for Payer: Clover Medicare Advantage	$8,189.54
Rate for Payer: EmblemHealth Commercial	$25,861.71
Rate for Payer: Humana Medicare Advantage	$8,879.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8,620.57
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11,678.16
Rate for Payer: Oxford Commercial	$11,677.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40
Rate for Payer: UnitedHealthcare Commercial	$12,906.00
Rate for Payer: UnitedHealthcare Community & State	$1,419.35
Rate for Payer: UnitedHealthcare Medicare Advantage	$8,620.57
Rate for Payer: Wellcare Medicare Advantage	$8,620.57
Rate for Payer: Wellpoint Medicaid Managed Care	$1,275.61

TENODESIS OF BICEPS TNDNAT EL

Facility

$44,916.00

Service Code	HCPCS 24340
Hospital Charge Code	16000614
Hospital Revenue Code	360
Min. Negotiated Rate	$6,737.40
Max. Negotiated Rate	$6,737.40
Rate for Payer: Qualcare PPO/HMO/WC	$6,737.40

TENOFOVIR 25MG TABLET

Facility

$326.89

Service Code	NDC 61958230101
Hospital Charge Code	6063943395
Hospital Revenue Code	250
Min. Negotiated Rate	$49.03
Max. Negotiated Rate	$49.03
Rate for Payer: Qualcare PPO/HMO/WC	$49.03

TENOFOVIR 25MG TABLET

Facility

$326.89

Service Code	NDC 61958230101
Hospital Charge Code	6063943395
Hospital Revenue Code	250
Min. Negotiated Rate	$9.28
Max. Negotiated Rate	$163.44
Rate for Payer: Aetna Commercial	$124.22
Rate for Payer: Aetna Medicare Advantage	$98.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$83.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$83.36
Rate for Payer: Cigna Commercial	$163.44
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$84.99
Rate for Payer: Oxford Commercial	$65.38
Rate for Payer: Qualcare PPO/HMO/WC	$49.03
Rate for Payer: UnitedHealthcare Commercial	$65.38
Rate for Payer: UnitedHealthcare Community & State	$10.33
Rate for Payer: Wellpoint Medicaid Managed Care	$9.28

TENOFOVIR 300 MG TAB

Facility

$250.11

Service Code	NDC 61958040101
Hospital Charge Code	60629216
Hospital Revenue Code	250
Min. Negotiated Rate	$37.52
Max. Negotiated Rate	$37.52
Rate for Payer: Qualcare PPO/HMO/WC	$37.52

TENOFOVIR 300 MG TAB

Facility

$250.11

Service Code	NDC 61958040101
Hospital Charge Code	60629216
Hospital Revenue Code	250
Min. Negotiated Rate	$7.10
Max. Negotiated Rate	$125.06
Rate for Payer: Aetna Commercial	$95.04
Rate for Payer: Aetna Medicare Advantage	$75.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.78
Rate for Payer: Cigna Commercial	$125.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$65.03
Rate for Payer: Oxford Commercial	$50.02
Rate for Payer: Qualcare PPO/HMO/WC	$37.52
Rate for Payer: UnitedHealthcare Commercial	$50.02
Rate for Payer: UnitedHealthcare Community & State	$7.90
Rate for Payer: Wellpoint Medicaid Managed Care	$7.10

TENOGLIDE TENSON PROTECTOR

Facility

$14,160.05

Service Code	HCPCS C9356
Hospital Charge Code	270688263
Hospital Revenue Code	278
Min. Negotiated Rate	$2,124.01
Max. Negotiated Rate	$3,426.73
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,832.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,426.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,124.01

TENOGLIDE TENSON PROTECTOR

Facility

$14,160.05

Service Code	HCPCS C9356
Hospital Charge Code	270688263
Hospital Revenue Code	278
Min. Negotiated Rate	$402.15
Max. Negotiated Rate	$7,080.02
Rate for Payer: Aetna Commercial	$5,380.82
Rate for Payer: Aetna Medicare Advantage	$4,248.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,610.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,610.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,832.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,610.81
Rate for Payer: Cigna Commercial	$7,080.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,426.73
Rate for Payer: Qualcare PPO/HMO/WC	$2,124.01
Rate for Payer: UnitedHealthcare Community & State	$447.46
Rate for Payer: Wellpoint Medicaid Managed Care	$402.15

Know your out-of-pocket cost for care.

All Charges