Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

WHIRLPOOL CQ

Facility

$185.00

Service Code	HCPCS 97022GP
Hospital Charge Code	904197022Q
Hospital Revenue Code	420
Min. Negotiated Rate	$27.75
Max. Negotiated Rate	$27.75
Rate for Payer: Qualcare PPO/HMO/WC	$27.75

WHITE ABSORBENT MAT

Facility

$15.00

Hospital Charge Code	270679631
Hospital Revenue Code	272
Min. Negotiated Rate	$2.25
Max. Negotiated Rate	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$2.25

WHITE ABSORBENT MAT

Facility

$15.00

Hospital Charge Code	270679631
Hospital Revenue Code	272
Min. Negotiated Rate	$0.43
Max. Negotiated Rate	$7.50
Rate for Payer: Aetna Commercial	$5.70
Rate for Payer: Aetna Medicare Advantage	$4.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.83
Rate for Payer: Cigna Commercial	$7.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.90
Rate for Payer: Oxford Commercial	$3.00
Rate for Payer: Qualcare PPO/HMO/WC	$2.25
Rate for Payer: UnitedHealthcare Commercial	$3.00
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.43

WHITE BLOOD COUNT (WBC)

Facility

$390.00

Service Code	HCPCS 85048
Hospital Charge Code	3002797
Hospital Revenue Code	301
Min. Negotiated Rate	$1.98
Max. Negotiated Rate	$195.00
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	$195.00
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	$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	$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	$11.08

WHITE BLOOD COUNT (WBC)

Facility

$390.00

Service Code	HCPCS 85048
Hospital Charge Code	3002797
Hospital Revenue Code	301
Min. Negotiated Rate	$58.50
Max. Negotiated Rate	$58.50
Rate for Payer: Qualcare PPO/HMO/WC	$58.50

WHITE PETROLATUM

Facility

$18.22

Service Code	NDC 168005321
Hospital Charge Code	6063943309
Hospital Revenue Code	250
Min. Negotiated Rate	$0.52
Max. Negotiated Rate	$9.11
Rate for Payer: Aetna Commercial	$6.92
Rate for Payer: Aetna Medicare Advantage	$5.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.65
Rate for Payer: Cigna Commercial	$9.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.74
Rate for Payer: Oxford Commercial	$3.64
Rate for Payer: Qualcare PPO/HMO/WC	$2.73
Rate for Payer: UnitedHealthcare Commercial	$3.64
Rate for Payer: UnitedHealthcare Community & State	$0.58
Rate for Payer: Wellpoint Medicaid Managed Care	$0.52

WHITE PETROLATUM

Facility

$18.22

Service Code	NDC 168005321
Hospital Charge Code	6063943309
Hospital Revenue Code	250
Min. Negotiated Rate	$2.73
Max. Negotiated Rate	$2.73
Rate for Payer: Qualcare PPO/HMO/WC	$2.73

WHOLE BLOOD

Facility

$1,204.00

Hospital Charge Code	38471028
Hospital Revenue Code	390
Min. Negotiated Rate	$34.19
Max. Negotiated Rate	$1,167.00
Rate for Payer: Aetna Commercial	$457.52
Rate for Payer: Aetna Medicare Advantage	$361.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$307.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$307.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$307.02
Rate for Payer: Cigna Commercial	$602.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$313.04
Rate for Payer: Oxford Commercial	$1,028.00
Rate for Payer: Qualcare PPO/HMO/WC	$180.60
Rate for Payer: UnitedHealthcare Commercial	$1,167.00
Rate for Payer: UnitedHealthcare Community & State	$38.05
Rate for Payer: Wellpoint Medicaid Managed Care	$34.19

WHOLE BLOOD

Facility

$1,204.00

Hospital Charge Code	38471028
Hospital Revenue Code	390
Min. Negotiated Rate	$180.60
Max. Negotiated Rate	$180.60
Rate for Payer: Qualcare PPO/HMO/WC	$180.60

WHOLEY 035 145 HI TORQ 1002702

Facility

$600.05

Hospital Charge Code	270661632S
Hospital Revenue Code	272
Min. Negotiated Rate	$90.01
Max. Negotiated Rate	$90.01
Rate for Payer: Qualcare PPO/HMO/WC	$90.01

WHOLEY 035 145 HI TORQ 1002702

Facility

$600.05

Hospital Charge Code	270661632
Hospital Revenue Code	272
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$300.02
Rate for Payer: Aetna Commercial	$228.02
Rate for Payer: Aetna Medicare Advantage	$180.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.01
Rate for Payer: Cigna Commercial	$300.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.01
Rate for Payer: Oxford Commercial	$120.01
Rate for Payer: Qualcare PPO/HMO/WC	$90.01
Rate for Payer: UnitedHealthcare Commercial	$120.01
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.04

WHOLEY 035 145 HI TORQ 1002702

Facility

$600.05

Hospital Charge Code	270661632S
Hospital Revenue Code	272
Min. Negotiated Rate	$17.04
Max. Negotiated Rate	$300.02
Rate for Payer: Aetna Commercial	$228.02
Rate for Payer: Aetna Medicare Advantage	$180.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$153.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$153.01
Rate for Payer: Cigna Commercial	$300.02
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$156.01
Rate for Payer: Oxford Commercial	$120.01
Rate for Payer: Qualcare PPO/HMO/WC	$90.01
Rate for Payer: UnitedHealthcare Commercial	$120.01
Rate for Payer: UnitedHealthcare Community & State	$18.96
Rate for Payer: Wellpoint Medicaid Managed Care	$17.04

WHOLEY 035 145 HI TORQ 1002702

Facility

$600.05

Hospital Charge Code	270661632
Hospital Revenue Code	272
Min. Negotiated Rate	$90.01
Max. Negotiated Rate	$90.01
Rate for Payer: Qualcare PPO/HMO/WC	$90.01

WILSON-COOK WIRE GUIDE

Facility

$313.00

Hospital Charge Code	270332077
Hospital Revenue Code	278
Min. Negotiated Rate	$8.89
Max. Negotiated Rate	$156.50
Rate for Payer: Aetna Commercial	$118.94
Rate for Payer: Aetna Medicare Advantage	$93.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.81
Rate for Payer: Cigna Commercial	$156.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.75
Rate for Payer: Qualcare PPO/HMO/WC	$46.95
Rate for Payer: UnitedHealthcare Community & State	$9.89
Rate for Payer: Wellpoint Medicaid Managed Care	$8.89

WILSON-COOK WIRE GUIDE

Facility

$313.00

Hospital Charge Code	270332077
Hospital Revenue Code	278
Min. Negotiated Rate	$46.95
Max. Negotiated Rate	$75.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$62.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$75.75
Rate for Payer: Qualcare PPO/HMO/WC	$46.95

WILSON FRAME PATIENT KIT

Facility

$133.75

Hospital Charge Code	270339536
Hospital Revenue Code	272
Min. Negotiated Rate	$20.06
Max. Negotiated Rate	$20.06
Rate for Payer: Qualcare PPO/HMO/WC	$20.06

WILSON FRAME PATIENT KIT

Facility

$133.75

Hospital Charge Code	270339536
Hospital Revenue Code	272
Min. Negotiated Rate	$3.80
Max. Negotiated Rate	$66.88
Rate for Payer: Aetna Commercial	$50.83
Rate for Payer: Aetna Medicare Advantage	$40.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.11
Rate for Payer: Cigna Commercial	$66.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.77
Rate for Payer: Oxford Commercial	$26.75
Rate for Payer: Qualcare PPO/HMO/WC	$20.06
Rate for Payer: UnitedHealthcare Commercial	$26.75
Rate for Payer: UnitedHealthcare Community & State	$4.23
Rate for Payer: Wellpoint Medicaid Managed Care	$3.80

WING BMT 360 TIB SM CRUCIATE

Facility

$3,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270687243
Hospital Revenue Code	278
Min. Negotiated Rate	$598.50
Max. Negotiated Rate	$965.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: Qualcare PPO/HMO/WC	$598.50

WING BMT 360 TIB SM CRUCIATE

Facility

$3,990.00

Service Code	HCPCS C1776
Hospital Charge Code	270687243
Hospital Revenue Code	278
Min. Negotiated Rate	$113.32
Max. Negotiated Rate	$1,995.00
Rate for Payer: Aetna Commercial	$1,516.20
Rate for Payer: Aetna Medicare Advantage	$1,197.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,017.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$798.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,017.45
Rate for Payer: Cigna Commercial	$1,995.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$965.58
Rate for Payer: Qualcare PPO/HMO/WC	$598.50
Rate for Payer: UnitedHealthcare Community & State	$126.08
Rate for Payer: Wellpoint Medicaid Managed Care	$113.32

WIPES BABY FRAGRANCE FREE

Facility

$148.40

Hospital Charge Code	270663231
Hospital Revenue Code	270
Min. Negotiated Rate	$22.26
Max. Negotiated Rate	$22.26
Rate for Payer: Qualcare PPO/HMO/WC	$22.26

WIPES BABY FRAGRANCE FREE

Facility

$148.40

Hospital Charge Code	270663231
Hospital Revenue Code	270
Min. Negotiated Rate	$4.21
Max. Negotiated Rate	$74.20
Rate for Payer: Aetna Commercial	$56.39
Rate for Payer: Aetna Medicare Advantage	$44.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$37.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$37.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$37.84
Rate for Payer: Cigna Commercial	$74.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$38.58
Rate for Payer: Oxford Commercial	$29.68
Rate for Payer: Qualcare PPO/HMO/WC	$22.26
Rate for Payer: UnitedHealthcare Commercial	$29.68
Rate for Payer: UnitedHealthcare Community & State	$4.69
Rate for Payer: Wellpoint Medicaid Managed Care	$4.21

WIRE 0.14

Facility

$900.00

Hospital Charge Code	270660505C
Hospital Revenue Code	272
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$135.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

WIRE 0.14

Facility

$900.00

Hospital Charge Code	270660505C
Hospital Revenue Code	272
Min. Negotiated Rate	$25.56
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$234.00
Rate for Payer: Oxford Commercial	$180.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Commercial	$180.00
Rate for Payer: UnitedHealthcare Community & State	$28.44
Rate for Payer: Wellpoint Medicaid Managed Care	$25.56

WIRE 1.25MM

Facility

$742.50

Service Code	HCPCS C1713
Hospital Charge Code	270692245
Hospital Revenue Code	278
Min. Negotiated Rate	$111.38
Max. Negotiated Rate	$179.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.69
Rate for Payer: Qualcare PPO/HMO/WC	$111.38

WIRE 1.25MM

Facility

$742.50

Service Code	HCPCS C1713
Hospital Charge Code	270692245
Hospital Revenue Code	278
Min. Negotiated Rate	$21.09
Max. Negotiated Rate	$371.25
Rate for Payer: Aetna Commercial	$282.15
Rate for Payer: Aetna Medicare Advantage	$222.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$189.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$189.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$148.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$189.34
Rate for Payer: Cigna Commercial	$371.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$179.69
Rate for Payer: Qualcare PPO/HMO/WC	$111.38
Rate for Payer: UnitedHealthcare Community & State	$23.46
Rate for Payer: Wellpoint Medicaid Managed Care	$21.09

Know your out-of-pocket cost for care.

All Charges