Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TRIAL SIMULATOR

Facility

$1,100.00

Hospital Charge Code	270703576
Hospital Revenue Code	270
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$165.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

TRIAMCINOLONE 0.5% 15GM

Facility

$67.74

Service Code	NDC 45802006535
Hospital Charge Code	6063943313
Hospital Revenue Code	250
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$33.87
Rate for Payer: Aetna Commercial	$25.74
Rate for Payer: Aetna Medicare Advantage	$20.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.27
Rate for Payer: Cigna Commercial	$33.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.61
Rate for Payer: Oxford Commercial	$13.55
Rate for Payer: Qualcare PPO/HMO/WC	$10.16
Rate for Payer: UnitedHealthcare Commercial	$13.55
Rate for Payer: UnitedHealthcare Community & State	$2.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.92

TRIAMCINOLONE 0.5% 15GM

Facility

$67.74

Service Code	NDC 45802006535
Hospital Charge Code	6063943313
Hospital Revenue Code	250
Min. Negotiated Rate	$10.16
Max. Negotiated Rate	$10.16
Rate for Payer: Qualcare PPO/HMO/WC	$10.16

TRIAMCINOLONE ACET .025%80GM

Facility

$67.74

Service Code	NDC 45802005436
Hospital Charge Code	606390494
Hospital Revenue Code	250
Min. Negotiated Rate	$1.92
Max. Negotiated Rate	$33.87
Rate for Payer: Aetna Commercial	$25.74
Rate for Payer: Aetna Medicare Advantage	$20.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.27
Rate for Payer: Cigna Commercial	$33.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.61
Rate for Payer: Oxford Commercial	$13.55
Rate for Payer: Qualcare PPO/HMO/WC	$10.16
Rate for Payer: UnitedHealthcare Commercial	$13.55
Rate for Payer: UnitedHealthcare Community & State	$2.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.92

TRIAMCINOLONE ACET .025%80GM

Facility

$67.74

Service Code	NDC 45802005436
Hospital Charge Code	606390494
Hospital Revenue Code	250
Min. Negotiated Rate	$10.16
Max. Negotiated Rate	$10.16
Rate for Payer: Qualcare PPO/HMO/WC	$10.16

TRIAMCINOLONE ACET INJ 40MG/ML

Facility

$68.74

Service Code	HCPCS J3301
Hospital Charge Code	6005409
Hospital Revenue Code	636
Min. Negotiated Rate	$10.31
Max. Negotiated Rate	$16.64
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Qualcare PPO/HMO/WC	$10.31

TRIAMCINOLONE ACET INJ 40MG/ML

Facility

$68.74

Service Code	HCPCS J3301
Hospital Charge Code	6005409
Hospital Revenue Code	636
Min. Negotiated Rate	$1.95
Max. Negotiated Rate	$34.37
Rate for Payer: Aetna Commercial	$26.12
Rate for Payer: Aetna Medicare Advantage	$20.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.53
Rate for Payer: Cigna Commercial	$34.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$16.64
Rate for Payer: Qualcare PPO/HMO/WC	$10.31
Rate for Payer: UnitedHealthcare Community & State	$2.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.95

TRIAMCINOLONE ACETONIDE

Facility

$37.39

Service Code	NDC 168000415
Hospital Charge Code	60634061
Hospital Revenue Code	250
Min. Negotiated Rate	$5.61
Max. Negotiated Rate	$5.61
Rate for Payer: Qualcare PPO/HMO/WC	$5.61

TRIAMCINOLONE ACETONIDE

Facility

$37.39

Service Code	NDC 168000415
Hospital Charge Code	60634061
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$18.70
Rate for Payer: Aetna Commercial	$14.21
Rate for Payer: Aetna Medicare Advantage	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.53
Rate for Payer: Cigna Commercial	$18.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.72
Rate for Payer: Oxford Commercial	$7.48
Rate for Payer: Qualcare PPO/HMO/WC	$5.61
Rate for Payer: UnitedHealthcare Commercial	$7.48
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

TRIAMCINOLONE ACETONIDE 0.25%

Facility

$29.82

Service Code	NDC 45802006335
Hospital Charge Code	6063943306
Hospital Revenue Code	250
Min. Negotiated Rate	$0.85
Max. Negotiated Rate	$14.91
Rate for Payer: Aetna Commercial	$11.33
Rate for Payer: Aetna Medicare Advantage	$8.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.60
Rate for Payer: Cigna Commercial	$14.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.75
Rate for Payer: Oxford Commercial	$5.96
Rate for Payer: Qualcare PPO/HMO/WC	$4.47
Rate for Payer: UnitedHealthcare Commercial	$5.96
Rate for Payer: UnitedHealthcare Community & State	$0.94
Rate for Payer: Wellpoint Medicaid Managed Care	$0.85

TRIAMCINOLONE ACETONIDE 0.25%

Facility

$29.82

Service Code	NDC 45802006335
Hospital Charge Code	6063943306
Hospital Revenue Code	250
Min. Negotiated Rate	$4.47
Max. Negotiated Rate	$4.47
Rate for Payer: Qualcare PPO/HMO/WC	$4.47

TRIAMCINOLONE DENTALPASTE 0.1%

Facility

$108.00

Service Code	NDC 64980032005
Hospital Charge Code	60628408
Hospital Revenue Code	250
Min. Negotiated Rate	$16.20
Max. Negotiated Rate	$16.20
Rate for Payer: Qualcare PPO/HMO/WC	$16.20

TRIAMCINOLONE DENTALPASTE 0.1%

Facility

$108.00

Service Code	NDC 64980032005
Hospital Charge Code	60628408
Hospital Revenue Code	250
Min. Negotiated Rate	$3.07
Max. Negotiated Rate	$54.00
Rate for Payer: Aetna Commercial	$41.04
Rate for Payer: Aetna Medicare Advantage	$32.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$27.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$27.54
Rate for Payer: Cigna Commercial	$54.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.08
Rate for Payer: Oxford Commercial	$21.60
Rate for Payer: Qualcare PPO/HMO/WC	$16.20
Rate for Payer: UnitedHealthcare Commercial	$21.60
Rate for Payer: UnitedHealthcare Community & State	$3.41
Rate for Payer: Wellpoint Medicaid Managed Care	$3.07

TRIAMCINOLONE INJ 50MG/5ML

Facility

$88.78

Service Code	HCPCS J3301
Hospital Charge Code	60628211
Hospital Revenue Code	636
Min. Negotiated Rate	$13.32
Max. Negotiated Rate	$21.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.48
Rate for Payer: Qualcare PPO/HMO/WC	$13.32

TRIAMCINOLONE INJ 50MG/5ML

Facility

$88.78

Service Code	HCPCS J3301
Hospital Charge Code	60628211
Hospital Revenue Code	636
Min. Negotiated Rate	$2.52
Max. Negotiated Rate	$44.39
Rate for Payer: Aetna Commercial	$33.74
Rate for Payer: Aetna Medicare Advantage	$26.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.64
Rate for Payer: Cigna Commercial	$44.39
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.48
Rate for Payer: Qualcare PPO/HMO/WC	$13.32
Rate for Payer: UnitedHealthcare Community & State	$2.81
Rate for Payer: Wellpoint Medicaid Managed Care	$2.52

TRIAMCINOLONE OINT 0.025%

Facility

$41.00

Service Code	NDC 45802005435
Hospital Charge Code	60628405
Hospital Revenue Code	250
Min. Negotiated Rate	$1.16
Max. Negotiated Rate	$20.50
Rate for Payer: Aetna Commercial	$15.58
Rate for Payer: Aetna Medicare Advantage	$12.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.46
Rate for Payer: Cigna Commercial	$20.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.66
Rate for Payer: Oxford Commercial	$8.20
Rate for Payer: Qualcare PPO/HMO/WC	$6.15
Rate for Payer: UnitedHealthcare Commercial	$8.20
Rate for Payer: UnitedHealthcare Community & State	$1.30
Rate for Payer: Wellpoint Medicaid Managed Care	$1.16

TRIAMCINOLONE OINT 0.025%

Facility

$41.00

Service Code	NDC 45802005435
Hospital Charge Code	60628405
Hospital Revenue Code	250
Min. Negotiated Rate	$6.15
Max. Negotiated Rate	$6.15
Rate for Payer: Qualcare PPO/HMO/WC	$6.15

TRIAMCINOLONE OINT 0.1% 15GM

Facility

$37.39

Service Code	NDC 168000615
Hospital Charge Code	60628406
Hospital Revenue Code	250
Min. Negotiated Rate	$1.06
Max. Negotiated Rate	$18.70
Rate for Payer: Aetna Commercial	$14.21
Rate for Payer: Aetna Medicare Advantage	$11.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.53
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.53
Rate for Payer: Cigna Commercial	$18.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.72
Rate for Payer: Oxford Commercial	$7.48
Rate for Payer: Qualcare PPO/HMO/WC	$5.61
Rate for Payer: UnitedHealthcare Commercial	$7.48
Rate for Payer: UnitedHealthcare Community & State	$1.18
Rate for Payer: Wellpoint Medicaid Managed Care	$1.06

TRIAMCINOLONE OINT 0.1% 15GM

Facility

$37.39

Service Code	NDC 168000615
Hospital Charge Code	60628406
Hospital Revenue Code	250
Min. Negotiated Rate	$5.61
Max. Negotiated Rate	$5.61
Rate for Payer: Qualcare PPO/HMO/WC	$5.61

TRIAMTERENE 37.5 MG/HCTZ 25MG

Facility

$4.00

Service Code	NDC 51079093501
Hospital Charge Code	6023410
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

TRIAMTERENE 37.5 MG/HCTZ 25MG

Facility

$4.00

Service Code	NDC 51079093501
Hospital Charge Code	6023410
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

TRIAMTERENE 50 MG CAP

Facility

$30.55

Service Code	NDC 59212000201
Hospital Charge Code	6063943256
Hospital Revenue Code	250
Min. Negotiated Rate	$4.58
Max. Negotiated Rate	$4.58
Rate for Payer: Qualcare PPO/HMO/WC	$4.58

TRIAMTERENE 50 MG CAP

Facility

$30.55

Service Code	NDC 59212000201
Hospital Charge Code	6063943256
Hospital Revenue Code	250
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$15.28
Rate for Payer: Aetna Commercial	$11.61
Rate for Payer: Aetna Medicare Advantage	$9.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.79
Rate for Payer: Cigna Commercial	$15.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.94
Rate for Payer: Oxford Commercial	$6.11
Rate for Payer: Qualcare PPO/HMO/WC	$4.58
Rate for Payer: UnitedHealthcare Commercial	$6.11
Rate for Payer: UnitedHealthcare Community & State	$0.97
Rate for Payer: Wellpoint Medicaid Managed Care	$0.87

TRIATH CR FEM COMP BD SZ3 RT

Facility

$10,529.45

Service Code	HCPCS C1776
Hospital Charge Code	270693337
Hospital Revenue Code	278
Min. Negotiated Rate	$299.04
Max. Negotiated Rate	$5,264.73
Rate for Payer: Aetna Commercial	$4,001.19
Rate for Payer: Aetna Medicare Advantage	$3,158.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,685.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,685.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,105.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,685.01
Rate for Payer: Cigna Commercial	$5,264.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,548.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,579.42
Rate for Payer: UnitedHealthcare Community & State	$332.73
Rate for Payer: Wellpoint Medicaid Managed Care	$299.04

TRIATH CR FEM COMP BD SZ3 RT

Facility

$10,529.45

Service Code	HCPCS C1776
Hospital Charge Code	270693337
Hospital Revenue Code	278
Min. Negotiated Rate	$1,579.42
Max. Negotiated Rate	$2,548.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,105.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,548.13
Rate for Payer: Qualcare PPO/HMO/WC	$1,579.42

Know your out-of-pocket cost for care.

All Charges