Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

TRIGLYCERIDES PERITONEAL

Facility

$39.50

Service Code	HCPCS 84478
Hospital Charge Code	39900144
Hospital Revenue Code	301
Min. Negotiated Rate	$5.92
Max. Negotiated Rate	$5.92
Rate for Payer: Qualcare PPO/HMO/WC	$5.92

TRIGLYCERIDES PERITONEAL

Facility

$39.50

Service Code	HCPCS 84478
Hospital Charge Code	39900144
Hospital Revenue Code	301
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$15.61
Rate for Payer: Aetna Medicare Advantage	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.82
Rate for Payer: Cigna Commercial	$19.75
Rate for Payer: Cigna Medicare Advantage	$5.74
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.27
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$5.92
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.74
Rate for Payer: Wellcare Medicare Advantage	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$1.12

TRIGLYCERIDES, SERUM

Facility

$667.59

Service Code	HCPCS 84478
Hospital Charge Code	3002615
Hospital Revenue Code	301
Min. Negotiated Rate	$4.59
Max. Negotiated Rate	$333.80
Rate for Payer: Aetna Commercial	$15.61
Rate for Payer: Aetna Medicare Advantage	$18.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$20.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$20.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$13.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$20.82
Rate for Payer: Cigna Commercial	$333.80
Rate for Payer: Cigna Medicare Advantage	$5.74
Rate for Payer: Clover Medicare Advantage	$5.45
Rate for Payer: EmblemHealth Commercial	$17.22
Rate for Payer: Humana Medicare Advantage	$5.91
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.74
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$173.57
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$100.14
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$4.59
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.74
Rate for Payer: Wellcare Medicare Advantage	$5.74
Rate for Payer: Wellpoint Medicaid Managed Care	$18.96

TRIGLYCERIDES, SERUM

Facility

$667.59

Service Code	HCPCS 84478
Hospital Charge Code	3002615
Hospital Revenue Code	301
Min. Negotiated Rate	$100.14
Max. Negotiated Rate	$100.14
Rate for Payer: Qualcare PPO/HMO/WC	$100.14

TRIHEXYPHENIDYL 2 MG TAB

Facility

$4.00

Service Code	NDC 591533501
Hospital Charge Code	60627420
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

TRIHEXYPHENIDYL 2 MG TAB

Facility

$4.00

Service Code	NDC 591533501
Hospital Charge Code	60627420
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

TRIIODOTHYRONINE T3;REVERSE

Facility

$111.00

Service Code	HCPCS 84482
Hospital Charge Code	38477132
Hospital Revenue Code	301
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$42.87
Rate for Payer: Aetna Medicare Advantage	$51.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$15.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$27.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.17
Rate for Payer: Cigna Commercial	$55.50
Rate for Payer: Cigna Medicare Advantage	$15.76
Rate for Payer: Clover Medicare Advantage	$14.97
Rate for Payer: EmblemHealth Commercial	$47.28
Rate for Payer: Humana Medicare Advantage	$16.23
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$15.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$28.86
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$16.65
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$12.61
Rate for Payer: UnitedHealthcare Medicare Advantage	$15.76
Rate for Payer: Wellcare Medicare Advantage	$15.76
Rate for Payer: Wellpoint Medicaid Managed Care	$3.15

TRIIODOTHYRONINE T3;REVERSE

Facility

$111.00

Service Code	HCPCS 84482
Hospital Charge Code	38477132
Hospital Revenue Code	301
Min. Negotiated Rate	$16.65
Max. Negotiated Rate	$16.65
Rate for Payer: Qualcare PPO/HMO/WC	$16.65

TRILAFON CONC/118ML

Facility

$26.13

Service Code	NDC 781804901
Hospital Charge Code	60634591
Hospital Revenue Code	250
Min. Negotiated Rate	$0.74
Max. Negotiated Rate	$13.06
Rate for Payer: Aetna Commercial	$9.93
Rate for Payer: Aetna Medicare Advantage	$7.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.66
Rate for Payer: Cigna Commercial	$13.06
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.79
Rate for Payer: Oxford Commercial	$5.23
Rate for Payer: Qualcare PPO/HMO/WC	$3.92
Rate for Payer: UnitedHealthcare Commercial	$5.23
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.74

TRILAFON CONC/118ML

Facility

$26.13

Service Code	NDC 781804901
Hospital Charge Code	60634591
Hospital Revenue Code	250
Min. Negotiated Rate	$3.92
Max. Negotiated Rate	$3.92
Rate for Payer: Qualcare PPO/HMO/WC	$3.92

TRILEPTAL

Facility

$124.10

Service Code	HCPCS 83789
Hospital Charge Code	39900429
Hospital Revenue Code	301
Min. Negotiated Rate	$3.52
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$65.58
Rate for Payer: Aetna Medicare Advantage	$78.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$87.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$87.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$24.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$16.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$87.46
Rate for Payer: Cigna Commercial	$62.05
Rate for Payer: Cigna Medicare Advantage	$24.11
Rate for Payer: Clover Medicare Advantage	$22.90
Rate for Payer: EmblemHealth Commercial	$72.33
Rate for Payer: Humana Medicare Advantage	$24.83
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$24.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.27
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$18.61
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$19.29
Rate for Payer: UnitedHealthcare Medicare Advantage	$24.11
Rate for Payer: Wellcare Medicare Advantage	$24.11
Rate for Payer: Wellpoint Medicaid Managed Care	$3.52

TRILEPTAL

Facility

$124.10

Service Code	HCPCS 83789
Hospital Charge Code	39900429
Hospital Revenue Code	301
Min. Negotiated Rate	$18.61
Max. Negotiated Rate	$18.61
Rate for Payer: Qualcare PPO/HMO/WC	$18.61

TRILEPTAL 600 MG TAB

Facility

$34.30

Service Code	NDC 54009920
Hospital Charge Code	60635626
Hospital Revenue Code	250
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$17.15
Rate for Payer: Aetna Commercial	$13.03
Rate for Payer: Aetna Medicare Advantage	$10.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.75
Rate for Payer: Cigna Commercial	$17.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.92
Rate for Payer: Oxford Commercial	$6.86
Rate for Payer: Qualcare PPO/HMO/WC	$5.14
Rate for Payer: UnitedHealthcare Commercial	$6.86
Rate for Payer: UnitedHealthcare Community & State	$1.08
Rate for Payer: Wellpoint Medicaid Managed Care	$0.97

TRILEPTAL 600 MG TAB

Facility

$34.30

Service Code	NDC 54009920
Hospital Charge Code	60635626
Hospital Revenue Code	250
Min. Negotiated Rate	$5.14
Max. Negotiated Rate	$5.14
Rate for Payer: Qualcare PPO/HMO/WC	$5.14

TRIMETHOBENZAMIDE 300 MG CAP

Facility

$21.51

Service Code	HCPCS Q0173
Hospital Charge Code	60629360
Hospital Revenue Code	636
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$10.76
Rate for Payer: Aetna Commercial	$8.17
Rate for Payer: Aetna Medicare Advantage	$6.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.49
Rate for Payer: Cigna Commercial	$10.76
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.21
Rate for Payer: Qualcare PPO/HMO/WC	$3.23
Rate for Payer: UnitedHealthcare Community & State	$0.68
Rate for Payer: Wellpoint Medicaid Managed Care	$0.61

TRIMETHOBENZAMIDE 300 MG CAP

Facility

$21.51

Service Code	HCPCS Q0173
Hospital Charge Code	60629360
Hospital Revenue Code	636
Min. Negotiated Rate	$3.23
Max. Negotiated Rate	$5.21
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.21
Rate for Payer: Qualcare PPO/HMO/WC	$3.23

TRIMETHOBENZAMIDE INJ200MG/2ML

Facility

$47.64

Service Code	HCPCS J3250
Hospital Charge Code	60628152
Hospital Revenue Code	636
Min. Negotiated Rate	$1.35
Max. Negotiated Rate	$23.82
Rate for Payer: Aetna Commercial	$18.10
Rate for Payer: Aetna Medicare Advantage	$14.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.15
Rate for Payer: Cigna Commercial	$23.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$7.15
Rate for Payer: UnitedHealthcare Community & State	$1.51
Rate for Payer: Wellpoint Medicaid Managed Care	$1.35

TRIMETHOBENZAMIDE INJ200MG/2ML

Facility

$47.64

Service Code	HCPCS J3250
Hospital Charge Code	60628152
Hospital Revenue Code	636
Min. Negotiated Rate	$7.15
Max. Negotiated Rate	$11.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.53
Rate for Payer: Qualcare PPO/HMO/WC	$7.15

TRIM FIX NAIL 4X100MM

Facility

$16,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270705015
Hospital Revenue Code	278
Min. Negotiated Rate	$461.50
Max. Negotiated Rate	$8,125.00
Rate for Payer: Aetna Commercial	$6,175.00
Rate for Payer: Aetna Medicare Advantage	$4,875.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,143.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,143.75
Rate for Payer: Cigna Commercial	$8,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,932.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,437.50
Rate for Payer: UnitedHealthcare Community & State	$513.50
Rate for Payer: Wellpoint Medicaid Managed Care	$461.50

TRIM FIX NAIL 4X100MM

Facility

$16,250.00

Service Code	HCPCS C1713
Hospital Charge Code	270705015
Hospital Revenue Code	278
Min. Negotiated Rate	$2,437.50
Max. Negotiated Rate	$3,932.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,250.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,932.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,437.50

TRIM IT PINS 1.5MMX100MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270653041
Hospital Revenue Code	278
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

TRIM IT PINS 1.5MMX100MM

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270653041
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

TRIM IT PINS 2.0

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270691911
Hospital Revenue Code	278
Min. Negotiated Rate	$49.70
Max. Negotiated Rate	$875.00
Rate for Payer: Aetna Commercial	$665.00
Rate for Payer: Aetna Medicare Advantage	$525.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$446.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$446.25
Rate for Payer: Cigna Commercial	$875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50
Rate for Payer: UnitedHealthcare Community & State	$55.30
Rate for Payer: Wellpoint Medicaid Managed Care	$49.70

TRIM IT PINS 2.0

Facility

$1,750.00

Service Code	HCPCS C1713
Hospital Charge Code	270691911
Hospital Revenue Code	278
Min. Negotiated Rate	$262.50
Max. Negotiated Rate	$423.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$350.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$423.50
Rate for Payer: Qualcare PPO/HMO/WC	$262.50

TRIM NAILS

Facility

$327.35

Service Code	HCPCS 11719
Hospital Charge Code	5770005
Hospital Revenue Code	450
Min. Negotiated Rate	$49.10
Max. Negotiated Rate	$49.10
Rate for Payer: Qualcare PPO/HMO/WC	$49.10

Know your out-of-pocket cost for care.

All Charges