Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TI-MESH 6 X 8- HERNIA

Facility

$552.00

Hospital Charge Code	270338795
Hospital Revenue Code	278
Min. Negotiated Rate	$15.68
Max. Negotiated Rate	$276.00
Rate for Payer: Aetna Commercial	$209.76
Rate for Payer: Aetna Medicare Advantage	$165.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$140.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$140.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$110.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$140.76
Rate for Payer: Cigna Commercial	$276.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$133.58
Rate for Payer: Qualcare PPO/HMO/WC	$82.80
Rate for Payer: UnitedHealthcare Community & State	$17.44
Rate for Payer: Wellpoint Medicaid Managed Care	$15.68

TIMOLOL MALEATE 0.5% 0.3ML OPT

Facility

$27.00

Service Code	HCPCS C1713
Hospital Charge Code	606390577
Hospital Revenue Code	250
Min. Negotiated Rate	$4.05
Max. Negotiated Rate	$4.05
Rate for Payer: Qualcare PPO/HMO/WC	$4.05

TIMOLOL MALEATE 0.5% 0.3ML OPT

Facility

$27.00

Service Code	HCPCS C1713
Hospital Charge Code	606390577
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$13.50
Rate for Payer: Aetna Commercial	$10.26
Rate for Payer: Aetna Medicare Advantage	$8.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.88
Rate for Payer: Cigna Commercial	$13.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.02
Rate for Payer: Oxford Commercial	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$4.05
Rate for Payer: UnitedHealthcare Commercial	$5.40
Rate for Payer: UnitedHealthcare Community & State	$0.85
Rate for Payer: Wellpoint Medicaid Managed Care	$0.77

TIMOLOL OPHTHALMIC 0.25% SOL

Facility

$100.50

Service Code	NDC 61314022605
Hospital Charge Code	60629863
Hospital Revenue Code	251
Min. Negotiated Rate	$2.85
Max. Negotiated Rate	$50.25
Rate for Payer: Aetna Commercial	$38.19
Rate for Payer: Aetna Medicare Advantage	$30.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.63
Rate for Payer: Cigna Commercial	$50.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.13
Rate for Payer: Oxford Commercial	$20.10
Rate for Payer: Qualcare PPO/HMO/WC	$15.07
Rate for Payer: UnitedHealthcare Commercial	$20.10
Rate for Payer: UnitedHealthcare Community & State	$3.18
Rate for Payer: Wellpoint Medicaid Managed Care	$2.85

TIMOLOL OPHTHALMIC 0.25% SOL

Facility

$100.50

Service Code	NDC 61314022605
Hospital Charge Code	60629863
Hospital Revenue Code	251
Min. Negotiated Rate	$15.07
Max. Negotiated Rate	$15.07
Rate for Payer: Qualcare PPO/HMO/WC	$15.07

TIMOLOL OPHTHALMIC 0.5% SOLN

Facility

$113.90

Service Code	NDC 61314022705
Hospital Charge Code	6006142
Hospital Revenue Code	251
Min. Negotiated Rate	$17.09
Max. Negotiated Rate	$17.09
Rate for Payer: Qualcare PPO/HMO/WC	$17.09

TIMOLOL OPHTHALMIC 0.5% SOLN

Facility

$113.90

Service Code	NDC 61314022705
Hospital Charge Code	6006142
Hospital Revenue Code	251
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$56.95
Rate for Payer: Aetna Commercial	$43.28
Rate for Payer: Aetna Medicare Advantage	$34.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.04
Rate for Payer: Cigna Commercial	$56.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.61
Rate for Payer: Oxford Commercial	$22.78
Rate for Payer: Qualcare PPO/HMO/WC	$17.09
Rate for Payer: UnitedHealthcare Commercial	$22.78
Rate for Payer: UnitedHealthcare Community & State	$3.60
Rate for Payer: Wellpoint Medicaid Managed Care	$3.23

TINCTURE OF BENZOIN PREP SPRAY

Facility

$283.95

Service Code	NDC 40565011182
Hospital Charge Code	606390066
Hospital Revenue Code	250
Min. Negotiated Rate	$8.06
Max. Negotiated Rate	$141.97
Rate for Payer: Aetna Commercial	$107.90
Rate for Payer: Aetna Medicare Advantage	$85.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.41
Rate for Payer: Cigna Commercial	$141.97
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.83
Rate for Payer: Oxford Commercial	$56.79
Rate for Payer: Qualcare PPO/HMO/WC	$42.59
Rate for Payer: UnitedHealthcare Commercial	$56.79
Rate for Payer: UnitedHealthcare Community & State	$8.97
Rate for Payer: Wellpoint Medicaid Managed Care	$8.06

TINCTURE OF BENZOIN PREP SPRAY

Facility

$283.95

Service Code	NDC 40565011182
Hospital Charge Code	606390066
Hospital Revenue Code	250
Min. Negotiated Rate	$42.59
Max. Negotiated Rate	$42.59
Rate for Payer: Qualcare PPO/HMO/WC	$42.59

TINED LEAD KIT - 120

Facility

$17,500.00

Hospital Charge Code	270702021
Hospital Revenue Code	278
Min. Negotiated Rate	$497.00
Max. Negotiated Rate	$8,750.00
Rate for Payer: Aetna Commercial	$6,650.00
Rate for Payer: Aetna Medicare Advantage	$5,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,462.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,462.50
Rate for Payer: Cigna Commercial	$8,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00
Rate for Payer: UnitedHealthcare Community & State	$553.00
Rate for Payer: Wellpoint Medicaid Managed Care	$497.00

TINED LEAD KIT - 120

Facility

$17,500.00

Hospital Charge Code	270702021
Hospital Revenue Code	278
Min. Negotiated Rate	$2,625.00
Max. Negotiated Rate	$4,235.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,235.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,625.00

TIOTROPIUM 18 MCG CAP FOR INH

Facility

$42.28

Service Code	NDC 597007547
Hospital Charge Code	60629366
Hospital Revenue Code	250
Min. Negotiated Rate	$6.34
Max. Negotiated Rate	$6.34
Rate for Payer: Qualcare PPO/HMO/WC	$6.34

TIOTROPIUM 18 MCG CAP FOR INH

Facility

$42.28

Service Code	NDC 597007547
Hospital Charge Code	60629366
Hospital Revenue Code	250
Min. Negotiated Rate	$1.20
Max. Negotiated Rate	$21.14
Rate for Payer: Aetna Commercial	$16.07
Rate for Payer: Aetna Medicare Advantage	$12.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.78
Rate for Payer: Cigna Commercial	$21.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.99
Rate for Payer: Oxford Commercial	$8.46
Rate for Payer: Qualcare PPO/HMO/WC	$6.34
Rate for Payer: UnitedHealthcare Commercial	$8.46
Rate for Payer: UnitedHealthcare Community & State	$1.34
Rate for Payer: Wellpoint Medicaid Managed Care	$1.20

TIP COTTON APPLICATOR STERILE

Facility

$2.70

Hospital Charge Code	270300055
Hospital Revenue Code	270
Min. Negotiated Rate	$0.08
Max. Negotiated Rate	$1.35
Rate for Payer: Aetna Commercial	$1.03
Rate for Payer: Aetna Medicare Advantage	$0.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.69
Rate for Payer: Cigna Commercial	$1.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.70
Rate for Payer: Oxford Commercial	$0.54
Rate for Payer: Qualcare PPO/HMO/WC	$0.41
Rate for Payer: UnitedHealthcare Commercial	$0.54
Rate for Payer: UnitedHealthcare Community & State	$0.09
Rate for Payer: Wellpoint Medicaid Managed Care	$0.08

TIP COTTON APPLICATOR STERILE

Facility

$2.70

Hospital Charge Code	270300055
Hospital Revenue Code	270
Min. Negotiated Rate	$0.41
Max. Negotiated Rate	$0.41
Rate for Payer: Qualcare PPO/HMO/WC	$0.41

TIP EXTENDERS

Facility

$1,805.00

Hospital Charge Code	270687912
Hospital Revenue Code	278
Min. Negotiated Rate	$270.75
Max. Negotiated Rate	$436.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$436.81
Rate for Payer: Qualcare PPO/HMO/WC	$270.75

TIP EXTENDERS

Facility

$1,805.00

Hospital Charge Code	270687912
Hospital Revenue Code	278
Min. Negotiated Rate	$51.26
Max. Negotiated Rate	$902.50
Rate for Payer: Aetna Commercial	$685.90
Rate for Payer: Aetna Medicare Advantage	$541.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$460.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$460.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$361.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$460.27
Rate for Payer: Cigna Commercial	$902.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$436.81
Rate for Payer: Qualcare PPO/HMO/WC	$270.75
Rate for Payer: UnitedHealthcare Community & State	$57.04
Rate for Payer: Wellpoint Medicaid Managed Care	$51.26

TIP GUARD

Facility

$9.75

Hospital Charge Code	270691527
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

TIP GUARD

Facility

$9.75

Hospital Charge Code	270691527
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$1.46
Rate for Payer: Qualcare PPO/HMO/WC	$1.46

TIP HIGH FLOW

Facility

$57.51

Hospital Charge Code	270681089
Hospital Revenue Code	272
Min. Negotiated Rate	$8.63
Max. Negotiated Rate	$8.63
Rate for Payer: Qualcare PPO/HMO/WC	$8.63

TIP HIGH FLOW

Facility

$57.51

Hospital Charge Code	270681089
Hospital Revenue Code	272
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$28.75
Rate for Payer: Aetna Commercial	$21.85
Rate for Payer: Aetna Medicare Advantage	$17.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.67
Rate for Payer: Cigna Commercial	$28.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.95
Rate for Payer: Oxford Commercial	$11.50
Rate for Payer: Qualcare PPO/HMO/WC	$8.63
Rate for Payer: UnitedHealthcare Commercial	$11.50
Rate for Payer: UnitedHealthcare Community & State	$1.82
Rate for Payer: Wellpoint Medicaid Managed Care	$1.63

TIP MINI FLAREDTURBO SONICS

Facility

$375.00

Hospital Charge Code	270653349
Hospital Revenue Code	278
Min. Negotiated Rate	$10.65
Max. Negotiated Rate	$187.50
Rate for Payer: Aetna Commercial	$142.50
Rate for Payer: Aetna Medicare Advantage	$112.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$95.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$95.62
Rate for Payer: Cigna Commercial	$187.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25
Rate for Payer: UnitedHealthcare Community & State	$11.85
Rate for Payer: Wellpoint Medicaid Managed Care	$10.65

TIP MINI FLAREDTURBO SONICS

Facility

$375.00

Hospital Charge Code	270653349
Hospital Revenue Code	278
Min. Negotiated Rate	$56.25
Max. Negotiated Rate	$90.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$75.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$90.75
Rate for Payer: Qualcare PPO/HMO/WC	$56.25

TIP NEEDLE DOUBLE DIAMOND

Facility

$695.00

Hospital Charge Code	270670712
Hospital Revenue Code	272
Min. Negotiated Rate	$19.74
Max. Negotiated Rate	$347.50
Rate for Payer: Aetna Commercial	$264.10
Rate for Payer: Aetna Medicare Advantage	$208.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$177.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$177.22
Rate for Payer: Cigna Commercial	$347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$180.70
Rate for Payer: Oxford Commercial	$139.00
Rate for Payer: Qualcare PPO/HMO/WC	$104.25
Rate for Payer: UnitedHealthcare Commercial	$139.00
Rate for Payer: UnitedHealthcare Community & State	$21.96
Rate for Payer: Wellpoint Medicaid Managed Care	$19.74

TIP NEEDLE DOUBLE DIAMOND

Facility

$695.00

Hospital Charge Code	270670712
Hospital Revenue Code	272
Min. Negotiated Rate	$104.25
Max. Negotiated Rate	$104.25
Rate for Payer: Qualcare PPO/HMO/WC	$104.25

Know your out-of-pocket cost for care.

All Charges