Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BTB TIGHT ROPE RT

Facility

$2,125.00

Service Code	HCPCS C1713
Hospital Charge Code	270656498
Hospital Revenue Code	278
Min. Negotiated Rate	$318.75
Max. Negotiated Rate	$514.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$425.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$514.25
Rate for Payer: Qualcare PPO/HMO/WC	$318.75

BTB TIGHTROPE WITH SUTURE

Facility

$2,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270678335
Hospital Revenue Code	278
Min. Negotiated Rate	$333.75
Max. Negotiated Rate	$538.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$445.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.45
Rate for Payer: Qualcare PPO/HMO/WC	$333.75

BTB TIGHTROPE WITH SUTURE

Facility

$2,225.00

Service Code	HCPCS C1713
Hospital Charge Code	270678335
Hospital Revenue Code	278
Min. Negotiated Rate	$63.19
Max. Negotiated Rate	$1,112.50
Rate for Payer: Aetna Commercial	$845.50
Rate for Payer: Aetna Medicare Advantage	$667.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$567.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$445.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$567.38
Rate for Payer: Cigna Commercial	$1,112.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$538.45
Rate for Payer: Qualcare PPO/HMO/WC	$333.75
Rate for Payer: UnitedHealthcare Community & State	$70.31
Rate for Payer: Wellpoint Medicaid Managed Care	$63.19

BTL SPRAY FILM BARRIER 28ML

Facility

$35.61

Hospital Charge Code	270649950
Hospital Revenue Code	270
Min. Negotiated Rate	$5.34
Max. Negotiated Rate	$5.34
Rate for Payer: Qualcare PPO/HMO/WC	$5.34

BTL SPRAY FILM BARRIER 28ML

Facility

$35.61

Hospital Charge Code	270649950
Hospital Revenue Code	270
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$17.80
Rate for Payer: Aetna Commercial	$13.53
Rate for Payer: Aetna Medicare Advantage	$10.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.08
Rate for Payer: Cigna Commercial	$17.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.26
Rate for Payer: Oxford Commercial	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$5.34
Rate for Payer: UnitedHealthcare Commercial	$7.12
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

BTL SPRAY FILM BARRIER 28ML

Facility

$35.61

Hospital Charge Code	2706499950
Hospital Revenue Code	270
Min. Negotiated Rate	$5.34
Max. Negotiated Rate	$5.34
Rate for Payer: Qualcare PPO/HMO/WC	$5.34

BTL SPRAY FILM BARRIER 28ML

Facility

$35.61

Hospital Charge Code	2706499950
Hospital Revenue Code	270
Min. Negotiated Rate	$1.01
Max. Negotiated Rate	$17.80
Rate for Payer: Aetna Commercial	$13.53
Rate for Payer: Aetna Medicare Advantage	$10.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.08
Rate for Payer: Cigna Commercial	$17.80
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.26
Rate for Payer: Oxford Commercial	$7.12
Rate for Payer: Qualcare PPO/HMO/WC	$5.34
Rate for Payer: UnitedHealthcare Commercial	$7.12
Rate for Payer: UnitedHealthcare Community & State	$1.13
Rate for Payer: Wellpoint Medicaid Managed Care	$1.01

BUDESONIDE 3 MG ER

Facility

$126.30

Service Code	NDC 378715501
Hospital Charge Code	60629914
Hospital Revenue Code	250
Min. Negotiated Rate	$18.95
Max. Negotiated Rate	$18.95
Rate for Payer: Qualcare PPO/HMO/WC	$18.95

BUDESONIDE 3 MG ER

Facility

$126.30

Service Code	NDC 378715501
Hospital Charge Code	60629914
Hospital Revenue Code	250
Min. Negotiated Rate	$3.59
Max. Negotiated Rate	$63.15
Rate for Payer: Aetna Commercial	$47.99
Rate for Payer: Aetna Medicare Advantage	$37.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$32.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$32.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$32.21
Rate for Payer: Cigna Commercial	$63.15
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$32.84
Rate for Payer: Oxford Commercial	$25.26
Rate for Payer: Qualcare PPO/HMO/WC	$18.95
Rate for Payer: UnitedHealthcare Commercial	$25.26
Rate for Payer: UnitedHealthcare Community & State	$3.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.59

BUDESONIDE INH 0.25MG/2ML

Facility

$70.08

Service Code	NDC 186198804
Hospital Charge Code	60629103
Hospital Revenue Code	250
Min. Negotiated Rate	$1.99
Max. Negotiated Rate	$35.04
Rate for Payer: Aetna Commercial	$26.63
Rate for Payer: Aetna Medicare Advantage	$21.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$17.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$17.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$17.87
Rate for Payer: Cigna Commercial	$35.04
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$18.22
Rate for Payer: Oxford Commercial	$14.02
Rate for Payer: Qualcare PPO/HMO/WC	$10.51
Rate for Payer: UnitedHealthcare Commercial	$14.02
Rate for Payer: UnitedHealthcare Community & State	$2.21
Rate for Payer: Wellpoint Medicaid Managed Care	$1.99

BUDESONIDE INH 0.25MG/2ML

Facility

$70.08

Service Code	NDC 186198804
Hospital Charge Code	60629103
Hospital Revenue Code	250
Min. Negotiated Rate	$10.51
Max. Negotiated Rate	$10.51
Rate for Payer: Qualcare PPO/HMO/WC	$10.51

BUDESONIDE INH 0.5MG/30ML

Facility

$82.48

Service Code	NDC 186198904
Hospital Charge Code	60629104
Hospital Revenue Code	250
Min. Negotiated Rate	$2.34
Max. Negotiated Rate	$41.24
Rate for Payer: Aetna Commercial	$31.34
Rate for Payer: Aetna Medicare Advantage	$24.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$21.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$21.03
Rate for Payer: Cigna Commercial	$41.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$21.44
Rate for Payer: Oxford Commercial	$16.50
Rate for Payer: Qualcare PPO/HMO/WC	$12.37
Rate for Payer: UnitedHealthcare Commercial	$16.50
Rate for Payer: UnitedHealthcare Community & State	$2.61
Rate for Payer: Wellpoint Medicaid Managed Care	$2.34

BUDESONIDE INH 0.5MG/30ML

Facility

$82.48

Service Code	NDC 186198904
Hospital Charge Code	60629104
Hospital Revenue Code	250
Min. Negotiated Rate	$12.37
Max. Negotiated Rate	$12.37
Rate for Payer: Qualcare PPO/HMO/WC	$12.37

BULB J PRATT 100CC SUI301305

Facility

$24.85

Hospital Charge Code	270600417
Hospital Revenue Code	270
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

BULB J PRATT 100CC SUI301305

Facility

$24.85

Hospital Charge Code	270600417
Hospital Revenue Code	270
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$9.44
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.46
Rate for Payer: Oxford Commercial	$4.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$4.97
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

BULB SUCTION

Facility

$16.00

Hospital Charge Code	270331434
Hospital Revenue Code	272
Min. Negotiated Rate	$0.45
Max. Negotiated Rate	$8.00
Rate for Payer: Aetna Commercial	$6.08
Rate for Payer: Aetna Medicare Advantage	$4.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.08
Rate for Payer: Cigna Commercial	$8.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.16
Rate for Payer: Oxford Commercial	$3.20
Rate for Payer: Qualcare PPO/HMO/WC	$2.40
Rate for Payer: UnitedHealthcare Commercial	$3.20
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.45

BULB SUCTION

Facility

$16.00

Hospital Charge Code	270331434
Hospital Revenue Code	272
Min. Negotiated Rate	$2.40
Max. Negotiated Rate	$2.40
Rate for Payer: Qualcare PPO/HMO/WC	$2.40

BULB SYRINGE IRRIGATION SET

Facility

$6.86

Service Code	HCPCS A4322
Hospital Charge Code	270649781
Hospital Revenue Code	272
Min. Negotiated Rate	$1.03
Max. Negotiated Rate	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$1.03

BULB SYRINGE IRRIGATION SET

Facility

$6.86

Service Code	HCPCS A4322
Hospital Charge Code	270649781
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.43
Rate for Payer: Aetna Commercial	$2.61
Rate for Payer: Aetna Medicare Advantage	$2.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.75
Rate for Payer: Cigna Commercial	$3.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.78
Rate for Payer: Oxford Commercial	$1.37
Rate for Payer: Qualcare PPO/HMO/WC	$1.03
Rate for Payer: UnitedHealthcare Commercial	$1.37
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

BULKAMID URET IMP BULKING SYST

Facility

$5,750.00

Service Code	HCPCS L8603
Hospital Charge Code	270697611
Hospital Revenue Code	278
Min. Negotiated Rate	$163.30
Max. Negotiated Rate	$2,875.00
Rate for Payer: Aetna Commercial	$2,185.00
Rate for Payer: Aetna Medicare Advantage	$1,725.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,466.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,466.25
Rate for Payer: Cigna Commercial	$2,875.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50
Rate for Payer: UnitedHealthcare Community & State	$181.70
Rate for Payer: Wellpoint Medicaid Managed Care	$163.30

BULKAMID URET IMP BULKING SYST

Facility

$5,750.00

Service Code	HCPCS L8603
Hospital Charge Code	270697611
Hospital Revenue Code	278
Min. Negotiated Rate	$862.50
Max. Negotiated Rate	$1,391.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$1,150.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,391.50
Rate for Payer: Qualcare PPO/HMO/WC	$862.50

BULK TWIST LOCK CABLE 64CM

Facility

$400.00

Hospital Charge Code	270671696
Hospital Revenue Code	272
Min. Negotiated Rate	$60.00
Max. Negotiated Rate	$60.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00

BULK TWIST LOCK CABLE 64CM

Facility

$400.00

Hospital Charge Code	270671696
Hospital Revenue Code	272
Min. Negotiated Rate	$11.36
Max. Negotiated Rate	$200.00
Rate for Payer: Aetna Commercial	$152.00
Rate for Payer: Aetna Medicare Advantage	$120.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$102.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$102.00
Rate for Payer: Cigna Commercial	$200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$104.00
Rate for Payer: Oxford Commercial	$80.00
Rate for Payer: Qualcare PPO/HMO/WC	$60.00
Rate for Payer: UnitedHealthcare Commercial	$80.00
Rate for Payer: UnitedHealthcare Community & State	$12.64
Rate for Payer: Wellpoint Medicaid Managed Care	$11.36

BULLDOG ATRAUMATIC VASCULAR CL

Facility

$4,694.55

Hospital Charge Code	270665287
Hospital Revenue Code	272
Min. Negotiated Rate	$704.18
Max. Negotiated Rate	$704.18
Rate for Payer: Qualcare PPO/HMO/WC	$704.18

BULLDOG ATRAUMATIC VASCULAR CL

Facility

$4,694.55

Hospital Charge Code	270665288
Hospital Revenue Code	272
Min. Negotiated Rate	$704.18
Max. Negotiated Rate	$704.18
Rate for Payer: Qualcare PPO/HMO/WC	$704.18

Know your out-of-pocket cost for care.

All Charges