Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BENZTROPINE 1 MG TAB

Facility

$4.00

Service Code	NDC 832108100
Hospital Charge Code	6022198
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BENZTROPINE 2 MG/2 ML INJ

Facility

$393.63

Service Code	HCPCS J0515
Hospital Charge Code	60627418
Hospital Revenue Code	636
Min. Negotiated Rate	$11.18
Max. Negotiated Rate	$196.81
Rate for Payer: Aetna Commercial	$149.58
Rate for Payer: Aetna Medicare Advantage	$118.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$100.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$100.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$100.38
Rate for Payer: Cigna Commercial	$196.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.26
Rate for Payer: Qualcare PPO/HMO/WC	$59.04
Rate for Payer: UnitedHealthcare Community & State	$12.44
Rate for Payer: Wellpoint Medicaid Managed Care	$11.18

BENZTROPINE 2 MG/2 ML INJ

Facility

$393.63

Service Code	HCPCS J0515
Hospital Charge Code	60627418
Hospital Revenue Code	636
Min. Negotiated Rate	$59.04
Max. Negotiated Rate	$95.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$95.26
Rate for Payer: Qualcare PPO/HMO/WC	$59.04

BENZTROPINE 2 MG TAB

Facility

$4.00

Service Code	NDC 603243921
Hospital Charge Code	60627419
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BENZTROPINE 2 MG TAB

Facility

$4.00

Service Code	NDC 603243921
Hospital Charge Code	60627419
Hospital Revenue Code	251
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

BETA-2 MICROGLOBULIN

Facility

$390.00

Service Code	HCPCS 82232
Hospital Charge Code	401082232
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BETA-2 MICROGLOBULIN

Facility

$390.00

Service Code	HCPCS 82232
Hospital Charge Code	401082232
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$44.01
Rate for Payer: Aetna Medicare Advantage	$52.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.69
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.18
Rate for Payer: Clover Medicare Advantage	$15.37
Rate for Payer: EmblemHealth Commercial	$48.54
Rate for Payer: Humana Medicare Advantage	$16.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.18
Rate for Payer: Wellcare Medicare Advantage	$16.18
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

BETA-2-MICROGLOBULIN

Facility

$174.00

Service Code	HCPCS 82232
Hospital Charge Code	38473077
Hospital Revenue Code	301
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

BETA-2-MICROGLOBULIN

Facility

$174.00

Service Code	HCPCS 82232
Hospital Charge Code	38473077
Hospital Revenue Code	301
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$44.01
Rate for Payer: Aetna Medicare Advantage	$52.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.69
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: Cigna Medicare Advantage	$16.18
Rate for Payer: Clover Medicare Advantage	$15.37
Rate for Payer: EmblemHealth Commercial	$48.54
Rate for Payer: Humana Medicare Advantage	$16.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.24
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.18
Rate for Payer: Wellcare Medicare Advantage	$16.18
Rate for Payer: Wellpoint Medicaid Managed Care	$4.94

BETA-2-MICROGLOBULIN,CSF

Facility

$390.00

Service Code	HCPCS 82232
Hospital Charge Code	39900327
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BETA-2-MICROGLOBULIN,CSF

Facility

$390.00

Service Code	HCPCS 82232
Hospital Charge Code	39900327
Hospital Revenue Code	301
Min. Negotiated Rate	$11.08
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$44.01
Rate for Payer: Aetna Medicare Advantage	$52.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$16.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$40.42
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.69
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$16.18
Rate for Payer: Clover Medicare Advantage	$15.37
Rate for Payer: EmblemHealth Commercial	$48.54
Rate for Payer: Humana Medicare Advantage	$16.67
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$16.18
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$101.40
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$58.50
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.94
Rate for Payer: UnitedHealthcare Medicare Advantage	$16.18
Rate for Payer: Wellcare Medicare Advantage	$16.18
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

BETA CAROTENE 25,000 IU SGL

Facility

$4.00

Service Code	NDC 10135012801
Hospital Charge Code	6063943185
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

BETA CAROTENE 25,000 IU SGL

Facility

$4.00

Service Code	NDC 10135012801
Hospital Charge Code	6063943185
Hospital Revenue Code	250
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

BETADINE AEROSOL SPRAY

Facility

$22.00

Hospital Charge Code	270331179
Hospital Revenue Code	272
Min. Negotiated Rate	$3.30
Max. Negotiated Rate	$3.30
Rate for Payer: Qualcare PPO/HMO/WC	$3.30

BETADINE AEROSOL SPRAY

Facility

$22.00

Hospital Charge Code	270331179
Hospital Revenue Code	272
Min. Negotiated Rate	$0.62
Max. Negotiated Rate	$11.00
Rate for Payer: Aetna Commercial	$8.36
Rate for Payer: Aetna Medicare Advantage	$6.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.61
Rate for Payer: Cigna Commercial	$11.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.72
Rate for Payer: Oxford Commercial	$4.40
Rate for Payer: Qualcare PPO/HMO/WC	$3.30
Rate for Payer: UnitedHealthcare Commercial	$4.40
Rate for Payer: UnitedHealthcare Community & State	$0.70
Rate for Payer: Wellpoint Medicaid Managed Care	$0.62

BETADINE SLN 4OZBTL 6761815004

Facility

$5.40

Hospital Charge Code	270643110
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$2.70
Rate for Payer: Aetna Commercial	$2.05
Rate for Payer: Aetna Medicare Advantage	$1.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.38
Rate for Payer: Cigna Commercial	$2.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.40
Rate for Payer: Oxford Commercial	$1.08
Rate for Payer: Qualcare PPO/HMO/WC	$0.81
Rate for Payer: UnitedHealthcare Commercial	$1.08
Rate for Payer: UnitedHealthcare Community & State	$0.17
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

BETADINE SLN 4OZBTL 6761815004

Facility

$5.40

Hospital Charge Code	270643110
Hospital Revenue Code	272
Min. Negotiated Rate	$0.81
Max. Negotiated Rate	$0.81
Rate for Payer: Qualcare PPO/HMO/WC	$0.81

BETADINE SOLUTION GAL.

Facility

$64.00

Hospital Charge Code	270331184
Hospital Revenue Code	272
Min. Negotiated Rate	$9.60
Max. Negotiated Rate	$9.60
Rate for Payer: Qualcare PPO/HMO/WC	$9.60

BETADINE SOLUTION GAL.

Facility

$64.00

Hospital Charge Code	270331184
Hospital Revenue Code	272
Min. Negotiated Rate	$1.82
Max. Negotiated Rate	$32.00
Rate for Payer: Aetna Commercial	$24.32
Rate for Payer: Aetna Medicare Advantage	$19.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$16.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$16.32
Rate for Payer: Cigna Commercial	$32.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Oxford Commercial	$12.80
Rate for Payer: Qualcare PPO/HMO/WC	$9.60
Rate for Payer: UnitedHealthcare Commercial	$12.80
Rate for Payer: UnitedHealthcare Community & State	$2.02
Rate for Payer: Wellpoint Medicaid Managed Care	$1.82

BETADINE SURG SCRUB GAL

Facility

$115.00

Hospital Charge Code	270331188
Hospital Revenue Code	272
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) PPO	$29.32
Rate for Payer: Cigna Commercial	$57.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.90
Rate for Payer: Oxford Commercial	$23.00
Rate for Payer: Qualcare PPO/HMO/WC	$17.25
Rate for Payer: UnitedHealthcare Commercial	$23.00
Rate for Payer: UnitedHealthcare Community & State	$3.63
Rate for Payer: Wellpoint Medicaid Managed Care	$3.27

BETADINE SURG SCRUB GAL

Facility

$115.00

Hospital Charge Code	270331188
Hospital Revenue Code	272
Min. Negotiated Rate	$17.25
Max. Negotiated Rate	$17.25
Rate for Payer: Qualcare PPO/HMO/WC	$17.25

BETAGAN 0.25% OPHTH/5ML

Facility

$164.69

Service Code	NDC 23438505
Hospital Charge Code	60632548
Hospital Revenue Code	250
Min. Negotiated Rate	$24.70
Max. Negotiated Rate	$24.70
Rate for Payer: Qualcare PPO/HMO/WC	$24.70

BETAGAN 0.25% OPHTH/5ML

Facility

$164.69

Service Code	NDC 23438505
Hospital Charge Code	60632548
Hospital Revenue Code	250
Min. Negotiated Rate	$4.68
Max. Negotiated Rate	$82.34
Rate for Payer: Aetna Commercial	$62.58
Rate for Payer: Aetna Medicare Advantage	$49.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$42.00
Rate for Payer: Cigna Commercial	$82.34
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$42.82
Rate for Payer: Oxford Commercial	$32.94
Rate for Payer: Qualcare PPO/HMO/WC	$24.70
Rate for Payer: UnitedHealthcare Commercial	$32.94
Rate for Payer: UnitedHealthcare Community & State	$5.20
Rate for Payer: Wellpoint Medicaid Managed Care	$4.68

BETAGAN 0.5% OPHTH/2ML

Facility

$84.76

Service Code	NDC 23438505
Hospital Charge Code	60632549
Hospital Revenue Code	250
Min. Negotiated Rate	$12.71
Max. Negotiated Rate	$12.71
Rate for Payer: Qualcare PPO/HMO/WC	$12.71

BETAGAN 0.5% OPHTH/2ML

Facility

$84.76

Service Code	NDC 23438505
Hospital Charge Code	60632549
Hospital Revenue Code	250
Min. Negotiated Rate	$2.41
Max. Negotiated Rate	$42.38
Rate for Payer: Aetna Commercial	$32.21
Rate for Payer: Aetna Medicare Advantage	$25.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.61
Rate for Payer: Cigna Commercial	$42.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.04
Rate for Payer: Oxford Commercial	$16.95
Rate for Payer: Qualcare PPO/HMO/WC	$12.71
Rate for Payer: UnitedHealthcare Commercial	$16.95
Rate for Payer: UnitedHealthcare Community & State	$2.68
Rate for Payer: Wellpoint Medicaid Managed Care	$2.41

Know your out-of-pocket cost for care.

All Charges