Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

VIDEX EC CAPS 400 MG

Facility

$115.17

Service Code	NDC 87667417
Hospital Charge Code	60635320
Hospital Revenue Code	250
Min. Negotiated Rate	$3.27
Max. Negotiated Rate	$57.59
Rate for Payer: Aetna Commercial	$43.76
Rate for Payer: Aetna Medicare Advantage	$34.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.37
Rate for Payer: Cigna Commercial	$57.59
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.94
Rate for Payer: Oxford Commercial	$23.03
Rate for Payer: Qualcare PPO/HMO/WC	$17.28
Rate for Payer: UnitedHealthcare Commercial	$23.03
Rate for Payer: UnitedHealthcare Community & State	$3.64
Rate for Payer: Wellpoint Medicaid Managed Care	$3.27

VIDEX EC CAPS 400 MG

Facility

$115.17

Service Code	NDC 87667417
Hospital Charge Code	60635320
Hospital Revenue Code	250
Min. Negotiated Rate	$17.28
Max. Negotiated Rate	$17.28
Rate for Payer: Qualcare PPO/HMO/WC	$17.28

VID SMOKING/HUMAN PHYS GN-16

Facility

$450.00

Hospital Charge Code	270632335
Hospital Revenue Code	272
Min. Negotiated Rate	$12.78
Max. Negotiated Rate	$225.00
Rate for Payer: Aetna Commercial	$171.00
Rate for Payer: Aetna Medicare Advantage	$135.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$114.75
Rate for Payer: Cigna Commercial	$225.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$117.00
Rate for Payer: Oxford Commercial	$90.00
Rate for Payer: Qualcare PPO/HMO/WC	$67.50
Rate for Payer: UnitedHealthcare Commercial	$90.00
Rate for Payer: UnitedHealthcare Community & State	$14.22
Rate for Payer: Wellpoint Medicaid Managed Care	$12.78

VID SMOKING/HUMAN PHYS GN-16

Facility

$450.00

Hospital Charge Code	270632335
Hospital Revenue Code	272
Min. Negotiated Rate	$67.50
Max. Negotiated Rate	$67.50
Rate for Payer: Qualcare PPO/HMO/WC	$67.50

VILEX HOMI IMPLANT 17X15MM

Facility

$7,125.00

Hospital Charge Code	270656769
Hospital Revenue Code	278
Min. Negotiated Rate	$202.35
Max. Negotiated Rate	$3,562.50
Rate for Payer: Aetna Commercial	$2,707.50
Rate for Payer: Aetna Medicare Advantage	$2,137.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,816.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,816.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,425.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,816.88
Rate for Payer: Cigna Commercial	$3,562.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,068.75
Rate for Payer: UnitedHealthcare Community & State	$225.15
Rate for Payer: Wellpoint Medicaid Managed Care	$202.35

VILEX HOMI IMPLANT 17X15MM

Facility

$7,125.00

Hospital Charge Code	270656769
Hospital Revenue Code	278
Min. Negotiated Rate	$1,068.75
Max. Negotiated Rate	$1,724.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,724.25
Rate for Payer: Qualcare PPO/HMO/WC	$1,068.75

VIMAX BONE MATRIX CARTRIDGE 10

Facility

$23,400.00

Service Code	HCPCS C1763
Hospital Charge Code	270697258
Hospital Revenue Code	278
Min. Negotiated Rate	$664.56
Max. Negotiated Rate	$11,700.00
Rate for Payer: Aetna Commercial	$8,892.00
Rate for Payer: Aetna Medicare Advantage	$7,020.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,967.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,967.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,680.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,967.00
Rate for Payer: Cigna Commercial	$11,700.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,662.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,510.00
Rate for Payer: UnitedHealthcare Community & State	$739.44
Rate for Payer: Wellpoint Medicaid Managed Care	$664.56

VIMAX BONE MATRIX CARTRIDGE 10

Facility

$23,400.00

Service Code	HCPCS C1763
Hospital Charge Code	270697258
Hospital Revenue Code	278
Min. Negotiated Rate	$3,510.00
Max. Negotiated Rate	$5,662.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,680.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,662.80
Rate for Payer: Qualcare PPO/HMO/WC	$3,510.00

VIMAX BONE MATRIX CARTRIDGE 5

Facility

$12,875.00

Service Code	HCPCS C1763
Hospital Charge Code	270697338
Hospital Revenue Code	278
Min. Negotiated Rate	$365.65
Max. Negotiated Rate	$6,437.50
Rate for Payer: Aetna Commercial	$4,892.50
Rate for Payer: Aetna Medicare Advantage	$3,862.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,283.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,283.12
Rate for Payer: Cigna Commercial	$6,437.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25
Rate for Payer: UnitedHealthcare Community & State	$406.85
Rate for Payer: Wellpoint Medicaid Managed Care	$365.65

VIMAX BONE MATRIX CARTRIDGE 5

Facility

$12,875.00

Service Code	HCPCS C1763
Hospital Charge Code	270697338
Hospital Revenue Code	278
Min. Negotiated Rate	$1,931.25
Max. Negotiated Rate	$3,115.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,575.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,115.75
Rate for Payer: Qualcare PPO/HMO/WC	$1,931.25

VIMAX BONE MATRIX VL 2CC

Facility

$6,600.00

Service Code	HCPCS C1763
Hospital Charge Code	270697764
Hospital Revenue Code	278
Min. Negotiated Rate	$990.00
Max. Negotiated Rate	$1,597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: Qualcare PPO/HMO/WC	$990.00

VIMAX BONE MATRIX VL 2CC

Facility

$6,600.00

Service Code	HCPCS C1763
Hospital Charge Code	270697764
Hospital Revenue Code	278
Min. Negotiated Rate	$187.44
Max. Negotiated Rate	$3,300.00
Rate for Payer: Aetna Commercial	$2,508.00
Rate for Payer: Aetna Medicare Advantage	$1,980.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,683.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,320.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,683.00
Rate for Payer: Cigna Commercial	$3,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,597.20
Rate for Payer: Qualcare PPO/HMO/WC	$990.00
Rate for Payer: UnitedHealthcare Community & State	$208.56
Rate for Payer: Wellpoint Medicaid Managed Care	$187.44

VINBLASTINE 10 MG INJ

Facility

$110.95

Service Code	HCPCS J9360
Hospital Charge Code	6005664
Hospital Revenue Code	636
Min. Negotiated Rate	$16.64
Max. Negotiated Rate	$26.85
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.85
Rate for Payer: Qualcare PPO/HMO/WC	$16.64

VINBLASTINE 10 MG INJ

Facility

$110.95

Service Code	HCPCS J9360
Hospital Charge Code	6005664
Hospital Revenue Code	636
Min. Negotiated Rate	$3.15
Max. Negotiated Rate	$55.48
Rate for Payer: Aetna Commercial	$42.16
Rate for Payer: Aetna Medicare Advantage	$33.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$28.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$28.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$28.29
Rate for Payer: Cigna Commercial	$55.48
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.85
Rate for Payer: Qualcare PPO/HMO/WC	$16.64
Rate for Payer: UnitedHealthcare Community & State	$3.51
Rate for Payer: Wellpoint Medicaid Managed Care	$3.15

VINCRISTINE 1 MG/ML INJ

Facility

$45.56

Service Code	HCPCS J9370
Hospital Charge Code	6005680
Hospital Revenue Code	636
Min. Negotiated Rate	$6.83
Max. Negotiated Rate	$11.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.03
Rate for Payer: Qualcare PPO/HMO/WC	$6.83

VINCRISTINE 1 MG/ML INJ

Facility

$45.56

Service Code	HCPCS J9370
Hospital Charge Code	6005680
Hospital Revenue Code	636
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$22.78
Rate for Payer: Aetna Commercial	$17.31
Rate for Payer: Aetna Medicare Advantage	$13.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$11.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$11.62
Rate for Payer: Cigna Commercial	$22.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.03
Rate for Payer: Qualcare PPO/HMO/WC	$6.83
Rate for Payer: UnitedHealthcare Community & State	$1.44
Rate for Payer: Wellpoint Medicaid Managed Care	$1.29

VINORELBINE 10 MG/ML INJ

Facility

$285.42

Service Code	HCPCS J9390
Hospital Charge Code	60627410
Hospital Revenue Code	636
Min. Negotiated Rate	$8.11
Max. Negotiated Rate	$142.71
Rate for Payer: Aetna Commercial	$108.46
Rate for Payer: Aetna Medicare Advantage	$85.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.78
Rate for Payer: Cigna Commercial	$142.71
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.07
Rate for Payer: Qualcare PPO/HMO/WC	$42.81
Rate for Payer: UnitedHealthcare Community & State	$9.02
Rate for Payer: Wellpoint Medicaid Managed Care	$8.11

VINORELBINE 10 MG/ML INJ

Facility

$285.42

Service Code	HCPCS J9390
Hospital Charge Code	60627410
Hospital Revenue Code	636
Min. Negotiated Rate	$42.81
Max. Negotiated Rate	$69.07
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$69.07
Rate for Payer: Qualcare PPO/HMO/WC	$42.81

VINYL CONNECTING TUBE 30CM

Facility

$12.52

Hospital Charge Code	270653764R
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

VINYL CONNECTING TUBE 30CM

Facility

$12.52

Hospital Charge Code	270653764S
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$6.26
Rate for Payer: Aetna Commercial	$4.76
Rate for Payer: Aetna Medicare Advantage	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.26
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$2.50
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

VINYL CONNECTING TUBE 30CM

Facility

$12.52

Hospital Charge Code	270653764N
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$6.26
Rate for Payer: Aetna Commercial	$4.76
Rate for Payer: Aetna Medicare Advantage	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.26
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$2.50
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

VINYL CONNECTING TUBE 30CM

Facility

$12.52

Hospital Charge Code	270653764R
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$6.26
Rate for Payer: Aetna Commercial	$4.76
Rate for Payer: Aetna Medicare Advantage	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.26
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$2.50
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

VINYL CONNECTING TUBE 30CM

Facility

$12.52

Hospital Charge Code	270653764S
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

VINYL CONNECTING TUBE 30CM

Facility

$12.52

Hospital Charge Code	270653764
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$6.26
Rate for Payer: Aetna Commercial	$4.76
Rate for Payer: Aetna Medicare Advantage	$3.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.19
Rate for Payer: Cigna Commercial	$6.26
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.26
Rate for Payer: Oxford Commercial	$2.50
Rate for Payer: Qualcare PPO/HMO/WC	$1.88
Rate for Payer: UnitedHealthcare Commercial	$2.50
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

VINYL CONNECTING TUBE 30CM

Facility

$12.52

Hospital Charge Code	270653764
Hospital Revenue Code	272
Min. Negotiated Rate	$1.88
Max. Negotiated Rate	$1.88
Rate for Payer: Qualcare PPO/HMO/WC	$1.88

Know your out-of-pocket cost for care.

All Charges