Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

BUR ZIM OVL ST 5.5MM 5092-238

Facility

$254.45

Hospital Charge Code	270606868
Hospital Revenue Code	272
Min. Negotiated Rate	$38.17
Max. Negotiated Rate	$38.17
Rate for Payer: Qualcare PPO/HMO/WC	$38.17

BUR ZIM SD CUT TAPER 5091-206

Facility

$312.00

Hospital Charge Code	270608841
Hospital Revenue Code	272
Min. Negotiated Rate	$8.86
Max. Negotiated Rate	$156.00
Rate for Payer: Aetna Commercial	$118.56
Rate for Payer: Aetna Medicare Advantage	$93.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$79.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$79.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$79.56
Rate for Payer: Cigna Commercial	$156.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.12
Rate for Payer: Oxford Commercial	$62.40
Rate for Payer: Qualcare PPO/HMO/WC	$46.80
Rate for Payer: UnitedHealthcare Commercial	$62.40
Rate for Payer: UnitedHealthcare Community & State	$9.86
Rate for Payer: Wellpoint Medicaid Managed Care	$8.86

BUR ZIM SD CUT TAPER 5091-206

Facility

$312.00

Hospital Charge Code	270608841
Hospital Revenue Code	272
Min. Negotiated Rate	$46.80
Max. Negotiated Rate	$46.80
Rate for Payer: Qualcare PPO/HMO/WC	$46.80

BUR ZIM ST CRBD 2.0MM 5092-224

Facility

$100.55

Hospital Charge Code	270605570
Hospital Revenue Code	272
Min. Negotiated Rate	$2.86
Max. Negotiated Rate	$50.27
Rate for Payer: Aetna Commercial	$38.21
Rate for Payer: Aetna Medicare Advantage	$30.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$25.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$25.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$25.64
Rate for Payer: Cigna Commercial	$50.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$26.14
Rate for Payer: Oxford Commercial	$20.11
Rate for Payer: Qualcare PPO/HMO/WC	$15.08
Rate for Payer: UnitedHealthcare Commercial	$20.11
Rate for Payer: UnitedHealthcare Community & State	$3.18
Rate for Payer: Wellpoint Medicaid Managed Care	$2.86

BUR ZIM ST CRBD 2.0MM 5092-224

Facility

$100.55

Hospital Charge Code	270605570
Hospital Revenue Code	272
Min. Negotiated Rate	$15.08
Max. Negotiated Rate	$15.08
Rate for Payer: Qualcare PPO/HMO/WC	$15.08

BUR ZIM ST CRBD 5.5MM 5091-138

Facility

$295.25

Hospital Charge Code	270607173
Hospital Revenue Code	272
Min. Negotiated Rate	$8.39
Max. Negotiated Rate	$147.62
Rate for Payer: Aetna Commercial	$112.19
Rate for Payer: Aetna Medicare Advantage	$88.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$75.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$75.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$75.29
Rate for Payer: Cigna Commercial	$147.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$76.77
Rate for Payer: Oxford Commercial	$59.05
Rate for Payer: Qualcare PPO/HMO/WC	$44.29
Rate for Payer: UnitedHealthcare Commercial	$59.05
Rate for Payer: UnitedHealthcare Community & State	$9.33
Rate for Payer: Wellpoint Medicaid Managed Care	$8.39

BUR ZIM ST CRBD 5.5MM 5091-138

Facility

$295.25

Hospital Charge Code	270607173
Hospital Revenue Code	272
Min. Negotiated Rate	$44.29
Max. Negotiated Rate	$44.29
Rate for Payer: Qualcare PPO/HMO/WC	$44.29

BUR ZIM ST RD 5.0MM 5092-266

Facility

$248.25

Hospital Charge Code	270607733
Hospital Revenue Code	272
Min. Negotiated Rate	$7.05
Max. Negotiated Rate	$124.12
Rate for Payer: Aetna Commercial	$94.33
Rate for Payer: Aetna Medicare Advantage	$74.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$63.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$63.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$63.30
Rate for Payer: Cigna Commercial	$124.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$64.55
Rate for Payer: Oxford Commercial	$49.65
Rate for Payer: Qualcare PPO/HMO/WC	$37.24
Rate for Payer: UnitedHealthcare Commercial	$49.65
Rate for Payer: UnitedHealthcare Community & State	$7.84
Rate for Payer: Wellpoint Medicaid Managed Care	$7.05

BUR ZIM ST RD 5.0MM 5092-266

Facility

$248.25

Hospital Charge Code	270607733
Hospital Revenue Code	272
Min. Negotiated Rate	$37.24
Max. Negotiated Rate	$37.24
Rate for Payer: Qualcare PPO/HMO/WC	$37.24

BUR ZIM ULPR AC 6.0MM 7021-381

Facility

$283.25

Hospital Charge Code	270603881
Hospital Revenue Code	272
Min. Negotiated Rate	$8.04
Max. Negotiated Rate	$141.62
Rate for Payer: Aetna Commercial	$107.64
Rate for Payer: Aetna Medicare Advantage	$84.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$72.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$72.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$72.23
Rate for Payer: Cigna Commercial	$141.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.64
Rate for Payer: Oxford Commercial	$56.65
Rate for Payer: Qualcare PPO/HMO/WC	$42.49
Rate for Payer: UnitedHealthcare Commercial	$56.65
Rate for Payer: UnitedHealthcare Community & State	$8.95
Rate for Payer: Wellpoint Medicaid Managed Care	$8.04

BUR ZIM ULPR AC 6.0MM 7021-381

Facility

$283.25

Hospital Charge Code	270603881
Hospital Revenue Code	272
Min. Negotiated Rate	$42.49
Max. Negotiated Rate	$42.49
Rate for Payer: Qualcare PPO/HMO/WC	$42.49

BUR ZIM ULPR RD 2.2MM 7021-236

Facility

$924.00

Hospital Charge Code	270603875
Hospital Revenue Code	272
Min. Negotiated Rate	$26.24
Max. Negotiated Rate	$462.00
Rate for Payer: Aetna Commercial	$351.12
Rate for Payer: Aetna Medicare Advantage	$277.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$235.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$235.62
Rate for Payer: Cigna Commercial	$462.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$240.24
Rate for Payer: Oxford Commercial	$184.80
Rate for Payer: Qualcare PPO/HMO/WC	$138.60
Rate for Payer: UnitedHealthcare Commercial	$184.80
Rate for Payer: UnitedHealthcare Community & State	$29.20
Rate for Payer: Wellpoint Medicaid Managed Care	$26.24

BUR ZIM ULPR RD 2.2MM 7021-236

Facility

$924.00

Hospital Charge Code	270603875
Hospital Revenue Code	272
Min. Negotiated Rate	$138.60
Max. Negotiated Rate	$138.60
Rate for Payer: Qualcare PPO/HMO/WC	$138.60

BUR ZIM ULPR RD 3.0MM 7021-137

Facility

$872.00

Hospital Charge Code	270603869
Hospital Revenue Code	272
Min. Negotiated Rate	$130.80
Max. Negotiated Rate	$130.80
Rate for Payer: Qualcare PPO/HMO/WC	$130.80

BUR ZIM ULPR RD 3.0MM 7021-137

Facility

$872.00

Hospital Charge Code	270603869
Hospital Revenue Code	272
Min. Negotiated Rate	$24.76
Max. Negotiated Rate	$436.00
Rate for Payer: Aetna Commercial	$331.36
Rate for Payer: Aetna Medicare Advantage	$261.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$222.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$222.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$222.36
Rate for Payer: Cigna Commercial	$436.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$226.72
Rate for Payer: Oxford Commercial	$174.40
Rate for Payer: Qualcare PPO/HMO/WC	$130.80
Rate for Payer: UnitedHealthcare Commercial	$174.40
Rate for Payer: UnitedHealthcare Community & State	$27.56
Rate for Payer: Wellpoint Medicaid Managed Care	$24.76

BUR ZIM ULPR RD 3.0MM 7021-237

Facility

$302.65

Hospital Charge Code	270603876
Hospital Revenue Code	272
Min. Negotiated Rate	$8.60
Max. Negotiated Rate	$151.32
Rate for Payer: Aetna Commercial	$115.01
Rate for Payer: Aetna Medicare Advantage	$90.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$77.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$77.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$77.18
Rate for Payer: Cigna Commercial	$151.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$78.69
Rate for Payer: Oxford Commercial	$60.53
Rate for Payer: Qualcare PPO/HMO/WC	$45.40
Rate for Payer: UnitedHealthcare Commercial	$60.53
Rate for Payer: UnitedHealthcare Community & State	$9.56
Rate for Payer: Wellpoint Medicaid Managed Care	$8.60

BUR ZIM ULPR RD 3.0MM 7021-237

Facility

$302.65

Hospital Charge Code	270603876
Hospital Revenue Code	272
Min. Negotiated Rate	$45.40
Max. Negotiated Rate	$45.40
Rate for Payer: Qualcare PPO/HMO/WC	$45.40

BUR ZIM ULPR RD 4.0MM 5092-164

Facility

$683.25

Hospital Charge Code	270603889
Hospital Revenue Code	272
Min. Negotiated Rate	$19.40
Max. Negotiated Rate	$341.62
Rate for Payer: Aetna Commercial	$259.63
Rate for Payer: Aetna Medicare Advantage	$204.97
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$174.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$174.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$174.23
Rate for Payer: Cigna Commercial	$341.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$177.65
Rate for Payer: Oxford Commercial	$136.65
Rate for Payer: Qualcare PPO/HMO/WC	$102.49
Rate for Payer: UnitedHealthcare Commercial	$136.65
Rate for Payer: UnitedHealthcare Community & State	$21.59
Rate for Payer: Wellpoint Medicaid Managed Care	$19.40

BUR ZIM ULPR RD 4.0MM 5092-164

Facility

$683.25

Hospital Charge Code	270603889
Hospital Revenue Code	272
Min. Negotiated Rate	$102.49
Max. Negotiated Rate	$102.49
Rate for Payer: Qualcare PPO/HMO/WC	$102.49

BUR ZIM ULPR TP 2.2MM 7021-815

Facility

$221.45

Hospital Charge Code	270603882
Hospital Revenue Code	272
Min. Negotiated Rate	$33.22
Max. Negotiated Rate	$33.22
Rate for Payer: Qualcare PPO/HMO/WC	$33.22

BUR ZIM ULPR TP 2.2MM 7021-815

Facility

$221.45

Hospital Charge Code	270603882
Hospital Revenue Code	272
Min. Negotiated Rate	$6.29
Max. Negotiated Rate	$110.72
Rate for Payer: Aetna Commercial	$84.15
Rate for Payer: Aetna Medicare Advantage	$66.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$56.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$56.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$56.47
Rate for Payer: Cigna Commercial	$110.72
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$57.58
Rate for Payer: Oxford Commercial	$44.29
Rate for Payer: Qualcare PPO/HMO/WC	$33.22
Rate for Payer: UnitedHealthcare Commercial	$44.29
Rate for Payer: UnitedHealthcare Community & State	$7.00
Rate for Payer: Wellpoint Medicaid Managed Care	$6.29

BUSPAR/10MG/TAB

Facility

$9.05

Service Code	NDC 51079098620
Hospital Charge Code	60632592
Hospital Revenue Code	250
Min. Negotiated Rate	$1.36
Max. Negotiated Rate	$1.36
Rate for Payer: Qualcare PPO/HMO/WC	$1.36

BUSPAR/10MG/TAB

Facility

$9.05

Service Code	NDC 51079098620
Hospital Charge Code	60632592
Hospital Revenue Code	250
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$4.53
Rate for Payer: Aetna Commercial	$3.44
Rate for Payer: Aetna Medicare Advantage	$2.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.31
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.31
Rate for Payer: Cigna Commercial	$4.53
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.35
Rate for Payer: Oxford Commercial	$1.81
Rate for Payer: Qualcare PPO/HMO/WC	$1.36
Rate for Payer: UnitedHealthcare Commercial	$1.81
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

BUSPIRONE 5 MG TAB

Facility

$5.16

Service Code	NDC 51079098520
Hospital Charge Code	60627854
Hospital Revenue Code	250
Min. Negotiated Rate	$0.77
Max. Negotiated Rate	$0.77
Rate for Payer: Qualcare PPO/HMO/WC	$0.77

BUSPIRONE 5 MG TAB

Facility

$5.16

Service Code	NDC 51079098520
Hospital Charge Code	60627854
Hospital Revenue Code	250
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$2.58
Rate for Payer: Aetna Commercial	$1.96
Rate for Payer: Aetna Medicare Advantage	$1.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.32
Rate for Payer: Cigna Commercial	$2.58
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.34
Rate for Payer: Oxford Commercial	$1.03
Rate for Payer: Qualcare PPO/HMO/WC	$0.77
Rate for Payer: UnitedHealthcare Commercial	$1.03
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

Know your out-of-pocket cost for care.

All Charges