Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CEPACOL LOZENGE

Facility

$4.00

Service Code	NDC 363070008
Hospital Charge Code	60628588
Hospital Revenue Code	250
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

CEPHALEXIN CAP 250MG

Facility

$5.63

Service Code	NDC 50268015111
Hospital Charge Code	60627264
Hospital Revenue Code	251
Min. Negotiated Rate	$0.16
Max. Negotiated Rate	$2.81
Rate for Payer: Aetna Commercial	$2.14
Rate for Payer: Aetna Medicare Advantage	$1.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.44
Rate for Payer: Cigna Commercial	$2.81
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.46
Rate for Payer: Oxford Commercial	$1.13
Rate for Payer: Qualcare PPO/HMO/WC	$0.84
Rate for Payer: UnitedHealthcare Commercial	$1.13
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.16

CEPHALEXIN CAP 250MG

Facility

$5.63

Service Code	NDC 50268015111
Hospital Charge Code	60627264
Hospital Revenue Code	251
Min. Negotiated Rate	$0.84
Max. Negotiated Rate	$0.84
Rate for Payer: Qualcare PPO/HMO/WC	$0.84

CEPHALEXIN CAP 500MG

Facility

$9.25

Service Code	NDC 93314701
Hospital Charge Code	60627265
Hospital Revenue Code	251
Min. Negotiated Rate	$1.39
Max. Negotiated Rate	$1.39
Rate for Payer: Qualcare PPO/HMO/WC	$1.39

CEPHALEXIN CAP 500MG

Facility

$9.25

Service Code	NDC 93314701
Hospital Charge Code	60627265
Hospital Revenue Code	251
Min. Negotiated Rate	$0.26
Max. Negotiated Rate	$4.62
Rate for Payer: Aetna Commercial	$3.52
Rate for Payer: Aetna Medicare Advantage	$2.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.36
Rate for Payer: Cigna Commercial	$4.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.40
Rate for Payer: Oxford Commercial	$1.85
Rate for Payer: Qualcare PPO/HMO/WC	$1.39
Rate for Payer: UnitedHealthcare Commercial	$1.85
Rate for Payer: UnitedHealthcare Community & State	$0.29
Rate for Payer: Wellpoint Medicaid Managed Care	$0.26

CEPHALEXIN SSP 125MG/5ML 100ML

Facility

$4.00

Service Code	NDC 93417573
Hospital Charge Code	60627263
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CEPHALEXIN SSP 125MG/5ML 100ML

Facility

$4.00

Service Code	NDC 93417573
Hospital Charge Code	60627263
Hospital Revenue Code	251
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

CEPHALEXIN SSP 250MG/5ML 100ML

Facility

$4.00

Service Code	NDC 93417773
Hospital Charge Code	6009302
Hospital Revenue Code	251
Min. Negotiated Rate	$0.11
Max. Negotiated Rate	$2.00
Rate for Payer: Aetna Commercial	$1.52
Rate for Payer: Aetna Medicare Advantage	$1.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.02
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.02
Rate for Payer: Cigna Commercial	$2.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.04
Rate for Payer: Oxford Commercial	$0.80
Rate for Payer: Qualcare PPO/HMO/WC	$0.60
Rate for Payer: UnitedHealthcare Commercial	$0.80
Rate for Payer: UnitedHealthcare Community & State	$0.13
Rate for Payer: Wellpoint Medicaid Managed Care	$0.11

CEPHALEXIN SSP 250MG/5ML 100ML

Facility

$4.00

Service Code	NDC 93417773
Hospital Charge Code	6009302
Hospital Revenue Code	251
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$0.60
Rate for Payer: Qualcare PPO/HMO/WC	$0.60

CEPHEID RNA RESP 4PLEX PANEL

Facility

$713.00

Service Code	HCPCS 0241U
Hospital Charge Code	40130241U
Hospital Revenue Code	300
Min. Negotiated Rate	$20.25
Max. Negotiated Rate	$356.50
Rate for Payer: Aetna Commercial	$270.94
Rate for Payer: Aetna Medicare Advantage	$213.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$181.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$181.81
Rate for Payer: Cigna Commercial	$356.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$185.38
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$106.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$22.53
Rate for Payer: Wellpoint Medicaid Managed Care	$20.25

CEPHEID RNA RESP 4PLEX PANEL

Facility

$713.00

Service Code	HCPCS 0241U
Hospital Charge Code	40130241U
Hospital Revenue Code	300
Min. Negotiated Rate	$106.95
Max. Negotiated Rate	$106.95
Rate for Payer: Qualcare PPO/HMO/WC	$106.95

CERACELL ORTHO MOLDABE FOAM 10

Facility

$18,250.00

Service Code	HCPCS C1765
Hospital Charge Code	270704181
Hospital Revenue Code	278
Min. Negotiated Rate	$518.30
Max. Negotiated Rate	$9,125.00
Rate for Payer: Aetna Commercial	$6,935.00
Rate for Payer: Aetna Medicare Advantage	$5,475.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,653.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,653.75
Rate for Payer: Cigna Commercial	$9,125.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50
Rate for Payer: UnitedHealthcare Community & State	$576.70
Rate for Payer: Wellpoint Medicaid Managed Care	$518.30

CERACELL ORTHO MOLDABE FOAM 10

Facility

$18,250.00

Service Code	HCPCS C1765
Hospital Charge Code	270704181
Hospital Revenue Code	278
Min. Negotiated Rate	$2,737.50
Max. Negotiated Rate	$4,416.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,650.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,416.50
Rate for Payer: Qualcare PPO/HMO/WC	$2,737.50

CERAMENT 10cc

Facility

$19,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270664901
Hospital Revenue Code	278
Min. Negotiated Rate	$562.32
Max. Negotiated Rate	$9,900.00
Rate for Payer: Aetna Commercial	$7,524.00
Rate for Payer: Aetna Medicare Advantage	$5,940.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,049.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,049.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,960.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,049.00
Rate for Payer: Cigna Commercial	$9,900.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,791.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,970.00
Rate for Payer: UnitedHealthcare Community & State	$625.68
Rate for Payer: Wellpoint Medicaid Managed Care	$562.32

CERAMENT 10cc

Facility

$19,800.00

Service Code	HCPCS C1713
Hospital Charge Code	270664901
Hospital Revenue Code	278
Min. Negotiated Rate	$2,970.00
Max. Negotiated Rate	$4,791.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,960.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,791.60
Rate for Payer: Qualcare PPO/HMO/WC	$2,970.00

CERAMENT BONE VOID 18ml

Facility

$23,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270690954
Hospital Revenue Code	278
Min. Negotiated Rate	$3,506.25
Max. Negotiated Rate	$5,656.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,675.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,656.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,506.25

CERAMENT BONE VOID 18ml

Facility

$23,375.00

Service Code	HCPCS C1713
Hospital Charge Code	270690954
Hospital Revenue Code	278
Min. Negotiated Rate	$663.85
Max. Negotiated Rate	$11,687.50
Rate for Payer: Aetna Commercial	$8,882.50
Rate for Payer: Aetna Medicare Advantage	$7,012.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5,960.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5,960.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$4,675.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5,960.62
Rate for Payer: Cigna Commercial	$11,687.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,656.75
Rate for Payer: Qualcare PPO/HMO/WC	$3,506.25
Rate for Payer: UnitedHealthcare Community & State	$738.65
Rate for Payer: Wellpoint Medicaid Managed Care	$663.85

CERCLAGE 1.0MM W/EYE 280MM

Facility

$336.00

Hospital Charge Code	270672158
Hospital Revenue Code	272
Min. Negotiated Rate	$50.40
Max. Negotiated Rate	$50.40
Rate for Payer: Qualcare PPO/HMO/WC	$50.40

CERCLAGE 1.0MM W/EYE 280MM

Facility

$336.00

Hospital Charge Code	270672158
Hospital Revenue Code	272
Min. Negotiated Rate	$9.54
Max. Negotiated Rate	$168.00
Rate for Payer: Aetna Commercial	$127.68
Rate for Payer: Aetna Medicare Advantage	$100.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$85.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$85.68
Rate for Payer: Cigna Commercial	$168.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$87.36
Rate for Payer: Oxford Commercial	$67.20
Rate for Payer: Qualcare PPO/HMO/WC	$50.40
Rate for Payer: UnitedHealthcare Commercial	$67.20
Rate for Payer: UnitedHealthcare Community & State	$10.62
Rate for Payer: Wellpoint Medicaid Managed Care	$9.54

CERCLAGE CERVIX PREGNANT VAG

Facility

$16,333.80

Service Code	HCPCS 59320
Hospital Charge Code	73190165
Hospital Revenue Code	720
Min. Negotiated Rate	$93.50
Max. Negotiated Rate	$13,950.60
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,950.60
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,246.79
Rate for Payer: Oxford Commercial	$4,053.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,450.07
Rate for Payer: UnitedHealthcare Commercial	$4,601.00
Rate for Payer: UnitedHealthcare Community & State	$516.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$463.88

CERCLAGE CERVIX PREGNANT VAG

Facility

$16,333.80

Service Code	HCPCS 59320
Hospital Charge Code	73190165
Hospital Revenue Code	720
Min. Negotiated Rate	$2,450.07
Max. Negotiated Rate	$2,450.07
Rate for Payer: Qualcare PPO/HMO/WC	$2,450.07

CERCLAGE CERVIX PREGNANT,VAG

Facility

$16,333.80

Service Code	HCPCS 59320
Hospital Charge Code	1600000486
Hospital Revenue Code	360
Min. Negotiated Rate	$463.88
Max. Negotiated Rate	$13,950.60
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,950.60
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,246.79
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,450.07
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$516.15
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellpoint Medicaid Managed Care	$463.88

CERCLAGE CERVIX PREGNANT,VAG

Facility

$16,333.80

Service Code	HCPCS 59320
Hospital Charge Code	1600000486
Hospital Revenue Code	360
Min. Negotiated Rate	$2,450.07
Max. Negotiated Rate	$2,450.07
Rate for Payer: Qualcare PPO/HMO/WC	$2,450.07

CERCLAGE OF UTENE CERVIX NONOB

Facility

$29,961.70

Service Code	HCPCS 57700
Hospital Charge Code	1600000728
Hospital Revenue Code	360
Min. Negotiated Rate	$946.79
Max. Negotiated Rate	$13,950.60
Rate for Payer: Aetna Commercial	$10,460.55
Rate for Payer: Aetna Medicare Advantage	$12,460.36
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13,950.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,845.79
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13,950.60
Rate for Payer: Cigna Commercial	$7,708.87
Rate for Payer: Cigna Medicare Advantage	$3,845.79
Rate for Payer: Clover Medicare Advantage	$3,653.50
Rate for Payer: EmblemHealth Commercial	$11,537.37
Rate for Payer: Humana Medicare Advantage	$3,961.16
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,845.79
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7,790.04
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$4,494.26
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$946.79
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare Medicare Advantage	$3,845.79
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,062.33
Rate for Payer: Wellpoint Medicaid Managed Care	$8,884.64

CERCLAGE OF UTENE CERVIX NONOB

Facility

$29,961.70

Service Code	HCPCS 57700
Hospital Charge Code	1600000728
Hospital Revenue Code	360
Min. Negotiated Rate	$4,494.26
Max. Negotiated Rate	$4,494.26
Rate for Payer: Qualcare PPO/HMO/WC	$4,494.26

Know your out-of-pocket cost for care.

All Charges