Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BETA HYDROXYBUTYRATE

Facility

$390.00

Service Code	HCPCS 82010
Hospital Charge Code	39900031
Hospital Revenue Code	307
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

BETA HYDROXYBUTYRATE

Facility

$390.00

Service Code	HCPCS 82010
Hospital Charge Code	39900031
Hospital Revenue Code	307
Min. Negotiated Rate	$6.54
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$22.22
Rate for Payer: Aetna Medicare Advantage	$26.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$8.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.64
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$8.17
Rate for Payer: Clover Medicare Advantage	$7.76
Rate for Payer: EmblemHealth Commercial	$24.51
Rate for Payer: Humana Medicare Advantage	$8.42
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$8.17
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	$6.54
Rate for Payer: UnitedHealthcare Medicare Advantage	$8.17
Rate for Payer: Wellcare Medicare Advantage	$8.17
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

BETAMETHASONE/CLOTRIMAZOLE

Facility

$995.35

Service Code	NDC 168025815
Hospital Charge Code	60628337
Hospital Revenue Code	250
Min. Negotiated Rate	$149.30
Max. Negotiated Rate	$149.30
Rate for Payer: Qualcare PPO/HMO/WC	$149.30

BETAMETHASONE/CLOTRIMAZOLE

Facility

$995.35

Service Code	NDC 168025815
Hospital Charge Code	60628337
Hospital Revenue Code	250
Min. Negotiated Rate	$28.27
Max. Negotiated Rate	$497.68
Rate for Payer: Aetna Commercial	$378.23
Rate for Payer: Aetna Medicare Advantage	$298.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$253.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$253.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$253.81
Rate for Payer: Cigna Commercial	$497.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$258.79
Rate for Payer: Oxford Commercial	$199.07
Rate for Payer: Qualcare PPO/HMO/WC	$149.30
Rate for Payer: UnitedHealthcare Commercial	$199.07
Rate for Payer: UnitedHealthcare Community & State	$31.45
Rate for Payer: Wellpoint Medicaid Managed Care	$28.27

BETAMETHASONE CRM 0.05% AF 15G

Facility

$254.27

Service Code	NDC 51672131001
Hospital Charge Code	606285574
Hospital Revenue Code	250
Min. Negotiated Rate	$7.22
Max. Negotiated Rate	$127.14
Rate for Payer: Aetna Commercial	$96.62
Rate for Payer: Aetna Medicare Advantage	$76.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.84
Rate for Payer: Cigna Commercial	$127.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$66.11
Rate for Payer: Oxford Commercial	$50.85
Rate for Payer: Qualcare PPO/HMO/WC	$38.14
Rate for Payer: UnitedHealthcare Commercial	$50.85
Rate for Payer: UnitedHealthcare Community & State	$8.03
Rate for Payer: Wellpoint Medicaid Managed Care	$7.22

BETAMETHASONE CRM 0.05% AF 15G

Facility

$254.27

Service Code	NDC 51672131001
Hospital Charge Code	606285574
Hospital Revenue Code	250
Min. Negotiated Rate	$38.14
Max. Negotiated Rate	$38.14
Rate for Payer: Qualcare PPO/HMO/WC	$38.14

BETAMETHASONE DIP 0.05% OINT

Facility

$187.40

Service Code	NDC 168004015
Hospital Charge Code	6063943315
Hospital Revenue Code	250
Min. Negotiated Rate	$5.32
Max. Negotiated Rate	$93.70
Rate for Payer: Aetna Commercial	$71.21
Rate for Payer: Aetna Medicare Advantage	$56.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$47.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$47.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$47.79
Rate for Payer: Cigna Commercial	$93.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$48.72
Rate for Payer: Oxford Commercial	$37.48
Rate for Payer: Qualcare PPO/HMO/WC	$28.11
Rate for Payer: UnitedHealthcare Commercial	$37.48
Rate for Payer: UnitedHealthcare Community & State	$5.92
Rate for Payer: Wellpoint Medicaid Managed Care	$5.32

BETAMETHASONE DIP 0.05% OINT

Facility

$187.40

Service Code	NDC 168004015
Hospital Charge Code	6063943315
Hospital Revenue Code	250
Min. Negotiated Rate	$28.11
Max. Negotiated Rate	$28.11
Rate for Payer: Qualcare PPO/HMO/WC	$28.11

BETAMETHASONE DIP 0.05%ONT 15G

Facility

$228.79

Hospital Charge Code	6063943372
Hospital Revenue Code	251
Min. Negotiated Rate	$34.32
Max. Negotiated Rate	$34.32
Rate for Payer: Qualcare PPO/HMO/WC	$34.32

BETAMETHASONE DIP 0.05%ONT 15G

Facility

$228.79

Hospital Charge Code	6063943372
Hospital Revenue Code	251
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$114.39
Rate for Payer: Aetna Commercial	$86.94
Rate for Payer: Aetna Medicare Advantage	$68.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$58.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$58.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$58.34
Rate for Payer: Cigna Commercial	$114.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$59.49
Rate for Payer: Oxford Commercial	$45.76
Rate for Payer: Qualcare PPO/HMO/WC	$34.32
Rate for Payer: UnitedHealthcare Commercial	$45.76
Rate for Payer: UnitedHealthcare Community & State	$7.23
Rate for Payer: Wellpoint Medicaid Managed Care	$6.50

BETAMETHASONE DIP 0.5% OINT

Facility

$31.02

Service Code	NDC 45802037635
Hospital Charge Code	606361047
Hospital Revenue Code	250
Min. Negotiated Rate	$4.65
Max. Negotiated Rate	$4.65
Rate for Payer: Qualcare PPO/HMO/WC	$4.65

BETAMETHASONE DIP 0.5% OINT

Facility

$31.02

Service Code	NDC 45802037635
Hospital Charge Code	606361047
Hospital Revenue Code	250
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$15.51
Rate for Payer: Aetna Commercial	$11.79
Rate for Payer: Aetna Medicare Advantage	$9.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.91
Rate for Payer: Cigna Commercial	$15.51
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.07
Rate for Payer: Oxford Commercial	$6.20
Rate for Payer: Qualcare PPO/HMO/WC	$4.65
Rate for Payer: UnitedHealthcare Commercial	$6.20
Rate for Payer: UnitedHealthcare Community & State	$0.98
Rate for Payer: Wellpoint Medicaid Managed Care	$0.88

BETAMETHASONE INJ 3MG/ML

Facility

$283.81

Service Code	HCPCS J0702
Hospital Charge Code	6000624
Hospital Revenue Code	636
Min. Negotiated Rate	$8.06
Max. Negotiated Rate	$141.91
Rate for Payer: Aetna Commercial	$107.85
Rate for Payer: Aetna Medicare Advantage	$85.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.37
Rate for Payer: Cigna Commercial	$141.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.68
Rate for Payer: Qualcare PPO/HMO/WC	$42.57
Rate for Payer: UnitedHealthcare Community & State	$8.97
Rate for Payer: Wellpoint Medicaid Managed Care	$8.06

BETAMETHASONE INJ 3MG/ML

Facility

$283.81

Service Code	HCPCS J0702
Hospital Charge Code	6000624
Hospital Revenue Code	636
Min. Negotiated Rate	$42.57
Max. Negotiated Rate	$68.68
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$68.68
Rate for Payer: Qualcare PPO/HMO/WC	$42.57

BETAMETHASONE OINT 45GM VAL

Facility

$680.59

Service Code	NDC 472038145
Hospital Charge Code	6000640
Hospital Revenue Code	251
Min. Negotiated Rate	$19.33
Max. Negotiated Rate	$340.30
Rate for Payer: Aetna Commercial	$258.62
Rate for Payer: Aetna Medicare Advantage	$204.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$173.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$173.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$173.55
Rate for Payer: Cigna Commercial	$340.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$176.95
Rate for Payer: Oxford Commercial	$136.12
Rate for Payer: Qualcare PPO/HMO/WC	$102.09
Rate for Payer: UnitedHealthcare Commercial	$136.12
Rate for Payer: UnitedHealthcare Community & State	$21.51
Rate for Payer: Wellpoint Medicaid Managed Care	$19.33

BETAMETHASONE OINT 45GM VAL

Facility

$680.59

Service Code	NDC 472038145
Hospital Charge Code	6000640
Hospital Revenue Code	251
Min. Negotiated Rate	$102.09
Max. Negotiated Rate	$102.09
Rate for Payer: Qualcare PPO/HMO/WC	$102.09

BETAMETHASONE VALERATE 0.

Facility

$482.40

Service Code	NDC 168004160
Hospital Charge Code	60632555
Hospital Revenue Code	250
Min. Negotiated Rate	$13.70
Max. Negotiated Rate	$241.20
Rate for Payer: Aetna Commercial	$183.31
Rate for Payer: Aetna Medicare Advantage	$144.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$123.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$123.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$123.01
Rate for Payer: Cigna Commercial	$241.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$125.42
Rate for Payer: Oxford Commercial	$96.48
Rate for Payer: Qualcare PPO/HMO/WC	$72.36
Rate for Payer: UnitedHealthcare Commercial	$96.48
Rate for Payer: UnitedHealthcare Community & State	$15.24
Rate for Payer: Wellpoint Medicaid Managed Care	$13.70

BETAMETHASONE VALERATE 0.

Facility

$482.40

Service Code	NDC 168004160
Hospital Charge Code	60632555
Hospital Revenue Code	250
Min. Negotiated Rate	$72.36
Max. Negotiated Rate	$72.36
Rate for Payer: Qualcare PPO/HMO/WC	$72.36

betamethasone valerate cr 0.1%

Facility

$129.13

Hospital Charge Code	6063943320
Hospital Revenue Code	250
Min. Negotiated Rate	$3.67
Max. Negotiated Rate	$64.56
Rate for Payer: Aetna Commercial	$49.07
Rate for Payer: Aetna Medicare Advantage	$38.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.93
Rate for Payer: Cigna Commercial	$64.56
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$33.57
Rate for Payer: Oxford Commercial	$25.83
Rate for Payer: Qualcare PPO/HMO/WC	$19.37
Rate for Payer: UnitedHealthcare Commercial	$25.83
Rate for Payer: UnitedHealthcare Community & State	$4.08
Rate for Payer: Wellpoint Medicaid Managed Care	$3.67

betamethasone valerate cr 0.1%

Facility

$129.13

Hospital Charge Code	6063943320
Hospital Revenue Code	250
Min. Negotiated Rate	$19.37
Max. Negotiated Rate	$19.37
Rate for Payer: Qualcare PPO/HMO/WC	$19.37

BETAPACE/160MG/CAP

Facility

$113.90

Service Code	NDC 70515010610
Hospital Charge Code	60634905
Hospital Revenue Code	250
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

BETAPACE/160MG/CAP

Facility

$113.90

Service Code	NDC 70515010610
Hospital Charge Code	60634905
Hospital Revenue Code	250
Min. Negotiated Rate	$17.09
Max. Negotiated Rate	$17.09
Rate for Payer: Qualcare PPO/HMO/WC	$17.09

BETAPACE/240MG/CAP

Facility

$47.24

Service Code	NDC 50419010710
Hospital Charge Code	60634906
Hospital Revenue Code	250
Min. Negotiated Rate	$1.34
Max. Negotiated Rate	$23.62
Rate for Payer: Aetna Commercial	$17.95
Rate for Payer: Aetna Medicare Advantage	$14.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.05
Rate for Payer: Cigna Commercial	$23.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$12.28
Rate for Payer: Oxford Commercial	$9.45
Rate for Payer: Qualcare PPO/HMO/WC	$7.09
Rate for Payer: UnitedHealthcare Commercial	$9.45
Rate for Payer: UnitedHealthcare Community & State	$1.49
Rate for Payer: Wellpoint Medicaid Managed Care	$1.34

BETAPACE/240MG/CAP

Facility

$47.24

Service Code	NDC 50419010710
Hospital Charge Code	60634906
Hospital Revenue Code	250
Min. Negotiated Rate	$7.09
Max. Negotiated Rate	$7.09
Rate for Payer: Qualcare PPO/HMO/WC	$7.09

BETHANACOL 5MG TAB

Facility

$4.76

Service Code	NDC 115951101
Hospital Charge Code	6063943064
Hospital Revenue Code	250
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.38
Rate for Payer: Aetna Commercial	$1.81
Rate for Payer: Aetna Medicare Advantage	$1.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.21
Rate for Payer: Cigna Commercial	$2.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.24
Rate for Payer: Oxford Commercial	$0.95
Rate for Payer: Qualcare PPO/HMO/WC	$0.71
Rate for Payer: UnitedHealthcare Commercial	$0.95
Rate for Payer: UnitedHealthcare Community & State	$0.15
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

Know your out-of-pocket cost for care.

All Charges