Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WATER, STERILE 50 ML SOL

Facility

$15.61

Service Code	NDC 409488750
Hospital Charge Code	6063943272
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$2.34
Rate for Payer: Qualcare PPO/HMO/WC	$2.34

WATER, STERILE 50 ML SOL

Facility

$15.61

Service Code	NDC 409488750
Hospital Charge Code	6063943272
Hospital Revenue Code	250
Min. Negotiated Rate	$0.44
Max. Negotiated Rate	$7.80
Rate for Payer: Aetna Commercial	$5.93
Rate for Payer: Aetna Medicare Advantage	$4.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.98
Rate for Payer: Cigna Commercial	$7.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.06
Rate for Payer: Oxford Commercial	$3.12
Rate for Payer: Qualcare PPO/HMO/WC	$2.34
Rate for Payer: UnitedHealthcare Commercial	$3.12
Rate for Payer: UnitedHealthcare Community & State	$0.49
Rate for Payer: Wellpoint Medicaid Managed Care	$0.44

WATER STERILE IN HANGING BOTTL

Facility

$36.00

Hospital Charge Code	270689129
Hospital Revenue Code	270
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$18.00
Rate for Payer: Aetna Commercial	$13.68
Rate for Payer: Aetna Medicare Advantage	$10.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.18
Rate for Payer: Cigna Commercial	$18.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.36
Rate for Payer: Oxford Commercial	$7.20
Rate for Payer: Qualcare PPO/HMO/WC	$5.40
Rate for Payer: UnitedHealthcare Commercial	$7.20
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.02

WATER STERILE IN HANGING BOTTL

Facility

$36.00

Hospital Charge Code	270689129
Hospital Revenue Code	270
Min. Negotiated Rate	$5.40
Max. Negotiated Rate	$5.40
Rate for Payer: Qualcare PPO/HMO/WC	$5.40

WATER TRAP AIRLIFE

Facility

$9.51

Hospital Charge Code	270600664
Hospital Revenue Code	272
Min. Negotiated Rate	$1.43
Max. Negotiated Rate	$1.43
Rate for Payer: Qualcare PPO/HMO/WC	$1.43

WATER TRAP AIRLIFE

Facility

$9.51

Hospital Charge Code	270600664
Hospital Revenue Code	272
Min. Negotiated Rate	$0.27
Max. Negotiated Rate	$4.75
Rate for Payer: Aetna Commercial	$3.61
Rate for Payer: Aetna Medicare Advantage	$2.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.43
Rate for Payer: Cigna Commercial	$4.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.47
Rate for Payer: Oxford Commercial	$1.90
Rate for Payer: Qualcare PPO/HMO/WC	$1.43
Rate for Payer: UnitedHealthcare Commercial	$1.90
Rate for Payer: UnitedHealthcare Community & State	$0.30
Rate for Payer: Wellpoint Medicaid Managed Care	$0.27

WAVEGUIDE INVUITY EIGR

Facility

$1,375.00

Hospital Charge Code	270663932
Hospital Revenue Code	270
Min. Negotiated Rate	$39.05
Max. Negotiated Rate	$687.50
Rate for Payer: Aetna Commercial	$522.50
Rate for Payer: Aetna Medicare Advantage	$412.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$350.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$350.62
Rate for Payer: Cigna Commercial	$687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$357.50
Rate for Payer: Oxford Commercial	$275.00
Rate for Payer: Qualcare PPO/HMO/WC	$206.25
Rate for Payer: UnitedHealthcare Commercial	$275.00
Rate for Payer: UnitedHealthcare Community & State	$43.45
Rate for Payer: Wellpoint Medicaid Managed Care	$39.05

WAVEGUIDE INVUITY EIGR

Facility

$1,375.00

Hospital Charge Code	270663932
Hospital Revenue Code	270
Min. Negotiated Rate	$206.25
Max. Negotiated Rate	$206.25
Rate for Payer: Qualcare PPO/HMO/WC	$206.25

WBC COUNT

Facility

$103.00

Service Code	HCPCS 85048
Hospital Charge Code	38473014
Hospital Revenue Code	301
Min. Negotiated Rate	$15.45
Max. Negotiated Rate	$15.45
Rate for Payer: Qualcare PPO/HMO/WC	$15.45

WBC COUNT

Facility

$103.00

Service Code	HCPCS 85048
Hospital Charge Code	38473014
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$6.91
Rate for Payer: Aetna Medicare Advantage	$8.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.21
Rate for Payer: Cigna Commercial	$51.50
Rate for Payer: Cigna Medicare Advantage	$2.54
Rate for Payer: Clover Medicare Advantage	$2.41
Rate for Payer: EmblemHealth Commercial	$7.62
Rate for Payer: Humana Medicare Advantage	$2.62
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.78
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$15.45
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$2.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$2.54
Rate for Payer: Wellcare Medicare Advantage	$2.54
Rate for Payer: Wellpoint Medicaid Managed Care	$2.93

WC 3 LAYER COMP BANDAGE

Facility

$38.00

Hospital Charge Code	9808265
Hospital Revenue Code	272
Min. Negotiated Rate	$5.70
Max. Negotiated Rate	$5.70
Rate for Payer: Qualcare PPO/HMO/WC	$5.70

WC 3 LAYER COMP BANDAGE

Facility

$38.00

Hospital Charge Code	9808265
Hospital Revenue Code	272
Min. Negotiated Rate	$1.08
Max. Negotiated Rate	$19.00
Rate for Payer: Aetna Commercial	$14.44
Rate for Payer: Aetna Medicare Advantage	$11.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.69
Rate for Payer: Cigna Commercial	$19.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.88
Rate for Payer: Oxford Commercial	$7.60
Rate for Payer: Qualcare PPO/HMO/WC	$5.70
Rate for Payer: UnitedHealthcare Commercial	$7.60
Rate for Payer: UnitedHealthcare Community & State	$1.20
Rate for Payer: Wellpoint Medicaid Managed Care	$1.08

WC ACCUCHECK

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	9808060
Hospital Revenue Code	301
Min. Negotiated Rate	$2.48
Max. Negotiated Rate	$195.00
Rate for Payer: Aetna Commercial	$13.71
Rate for Payer: Aetna Medicare Advantage	$16.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$5.04
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.28
Rate for Payer: Cigna Commercial	$195.00
Rate for Payer: Cigna Medicare Advantage	$5.04
Rate for Payer: Clover Medicare Advantage	$4.79
Rate for Payer: EmblemHealth Commercial	$15.12
Rate for Payer: Humana Medicare Advantage	$5.19
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$5.04
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	$4.03
Rate for Payer: UnitedHealthcare Medicare Advantage	$5.04
Rate for Payer: Wellcare Medicare Advantage	$5.04
Rate for Payer: Wellpoint Medicaid Managed Care	$11.08

WC ACCUCHECK

Facility

$390.00

Service Code	HCPCS 82948
Hospital Charge Code	9808060
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WC ACELLULAR DERMAL TISS MATRI

Facility

$2,653.00

Service Code	HCPCS Q4100
Hospital Charge Code	9808270
Hospital Revenue Code	636
Min. Negotiated Rate	$397.95
Max. Negotiated Rate	$642.03
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.03
Rate for Payer: Qualcare PPO/HMO/WC	$397.95

WC ACELLULAR DERMAL TISS MATRI

Facility

$2,653.00

Service Code	HCPCS Q4100
Hospital Charge Code	9808270
Hospital Revenue Code	636
Min. Negotiated Rate	$75.35
Max. Negotiated Rate	$1,326.50
Rate for Payer: Aetna Commercial	$1,008.14
Rate for Payer: Aetna Medicare Advantage	$795.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$676.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$676.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$676.51
Rate for Payer: Cigna Commercial	$1,326.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$642.03
Rate for Payer: Qualcare PPO/HMO/WC	$397.95
Rate for Payer: UnitedHealthcare Community & State	$83.83
Rate for Payer: Wellpoint Medicaid Managed Care	$75.35

WC ACELLULAR XENOGRAFT 1ST 100

Facility

$1,183.95

Hospital Charge Code	9800250
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC ACELLULAR XENOGRAFT 1ST 100

Facility

$1,183.95

Hospital Charge Code	9800250
Hospital Revenue Code	510
Min. Negotiated Rate	$33.62
Max. Negotiated Rate	$591.98
Rate for Payer: Aetna Commercial	$449.90
Rate for Payer: Aetna Medicare Advantage	$355.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$591.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.83
Rate for Payer: Qualcare PPO/HMO/WC	$177.59
Rate for Payer: UnitedHealthcare Community & State	$37.41
Rate for Payer: Wellpoint Medicaid Managed Care	$33.62

WC ACELL XENOGRAFT 1ST 100 ADD

Facility

$1,183.95

Hospital Charge Code	9800255
Hospital Revenue Code	510
Min. Negotiated Rate	$33.62
Max. Negotiated Rate	$591.98
Rate for Payer: Aetna Commercial	$449.90
Rate for Payer: Aetna Medicare Advantage	$355.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$301.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$301.91
Rate for Payer: Cigna Commercial	$591.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$307.83
Rate for Payer: Qualcare PPO/HMO/WC	$177.59
Rate for Payer: UnitedHealthcare Community & State	$37.41
Rate for Payer: Wellpoint Medicaid Managed Care	$33.62

WC ACELL XENOGRAFT 1ST 100 ADD

Facility

$1,183.95

Hospital Charge Code	9800255
Hospital Revenue Code	510
Min. Negotiated Rate	$177.59
Max. Negotiated Rate	$177.59
Rate for Payer: Qualcare PPO/HMO/WC	$177.59

WC ACTICOAT SILVER WOUND DRESS

Facility

$226.00

Service Code	HCPCS A9270
Hospital Charge Code	9808160
Hospital Revenue Code	272
Min. Negotiated Rate	$33.90
Max. Negotiated Rate	$33.90
Rate for Payer: Qualcare PPO/HMO/WC	$33.90

WC ACTICOAT SILVER WOUND DRESS

Facility

$226.00

Service Code	HCPCS A9270
Hospital Charge Code	9808160
Hospital Revenue Code	272
Min. Negotiated Rate	$6.42
Max. Negotiated Rate	$113.00
Rate for Payer: Aetna Commercial	$85.88
Rate for Payer: Aetna Medicare Advantage	$67.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$57.63
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$57.63
Rate for Payer: Cigna Commercial	$113.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$58.76
Rate for Payer: Oxford Commercial	$45.20
Rate for Payer: Qualcare PPO/HMO/WC	$33.90
Rate for Payer: UnitedHealthcare Commercial	$45.20
Rate for Payer: UnitedHealthcare Community & State	$7.14
Rate for Payer: Wellpoint Medicaid Managed Care	$6.42

WC ALLEVYN AG ADHESIVE 5 X %

Facility

$29.00

Service Code	HCPCS A6212
Hospital Charge Code	9808145
Hospital Revenue Code	272
Min. Negotiated Rate	$4.35
Max. Negotiated Rate	$4.35
Rate for Payer: Qualcare PPO/HMO/WC	$4.35

WC ALLEVYN AG ADHESIVE 5 X %

Facility

$29.00

Service Code	HCPCS A6212
Hospital Charge Code	9808145
Hospital Revenue Code	272
Min. Negotiated Rate	$0.82
Max. Negotiated Rate	$14.50
Rate for Payer: Aetna Commercial	$11.02
Rate for Payer: Aetna Medicare Advantage	$8.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.39
Rate for Payer: Cigna Commercial	$14.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.54
Rate for Payer: Oxford Commercial	$5.80
Rate for Payer: Qualcare PPO/HMO/WC	$4.35
Rate for Payer: UnitedHealthcare Commercial	$5.80
Rate for Payer: UnitedHealthcare Community & State	$0.92
Rate for Payer: Wellpoint Medicaid Managed Care	$0.82

WC ALLEVYN DRSNG >48SQ IN W/O

Facility

$24.00

Service Code	HCPCS A6211
Hospital Charge Code	9808130
Hospital Revenue Code	272
Min. Negotiated Rate	$0.68
Max. Negotiated Rate	$12.00
Rate for Payer: Aetna Commercial	$9.12
Rate for Payer: Aetna Medicare Advantage	$7.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.12
Rate for Payer: Cigna Commercial	$12.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.24
Rate for Payer: Oxford Commercial	$4.80
Rate for Payer: Qualcare PPO/HMO/WC	$3.60
Rate for Payer: UnitedHealthcare Commercial	$4.80
Rate for Payer: UnitedHealthcare Community & State	$0.76
Rate for Payer: Wellpoint Medicaid Managed Care	$0.68

Know your out-of-pocket cost for care.

All Charges