Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

COBAN 4 ROLL STER 1584S

Facility

$10.50

Hospital Charge Code	270600350
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$5.25
Rate for Payer: Aetna Commercial	$3.99
Rate for Payer: Aetna Medicare Advantage	$3.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.68
Rate for Payer: Cigna Commercial	$5.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.73
Rate for Payer: Oxford Commercial	$2.10
Rate for Payer: Qualcare PPO/HMO/WC	$1.57
Rate for Payer: UnitedHealthcare Commercial	$2.10
Rate for Payer: UnitedHealthcare Community & State	$0.33
Rate for Payer: Wellpoint Medicaid Managed Care	$0.30

COBAN SELF ADHERE WRAP RAINBOW

Facility

$5.83

Hospital Charge Code	270657861
Hospital Revenue Code	270
Min. Negotiated Rate	$0.87
Max. Negotiated Rate	$0.87
Rate for Payer: Qualcare PPO/HMO/WC	$0.87

COBAN SELF ADHERE WRAP RAINBOW

Facility

$5.83

Hospital Charge Code	270657861
Hospital Revenue Code	270
Min. Negotiated Rate	$0.17
Max. Negotiated Rate	$2.92
Rate for Payer: Aetna Commercial	$2.22
Rate for Payer: Aetna Medicare Advantage	$1.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.49
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.49
Rate for Payer: Cigna Commercial	$2.92
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.52
Rate for Payer: Oxford Commercial	$1.17
Rate for Payer: Qualcare PPO/HMO/WC	$0.87
Rate for Payer: UnitedHealthcare Commercial	$1.17
Rate for Payer: UnitedHealthcare Community & State	$0.18
Rate for Payer: Wellpoint Medicaid Managed Care	$0.17

COBAN WRAP SELF ADEHERENT 1

Facility

$2.23

Hospital Charge Code	270651845
Hospital Revenue Code	270
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$0.33
Rate for Payer: Qualcare PPO/HMO/WC	$0.33

COBAN WRAP SELF ADEHERENT 1

Facility

$2.23

Hospital Charge Code	270651845
Hospital Revenue Code	270
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.11
Rate for Payer: Aetna Commercial	$0.85
Rate for Payer: Aetna Medicare Advantage	$0.67
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.57
Rate for Payer: Cigna Commercial	$1.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.58
Rate for Payer: Oxford Commercial	$0.45
Rate for Payer: Qualcare PPO/HMO/WC	$0.33
Rate for Payer: UnitedHealthcare Commercial	$0.45
Rate for Payer: UnitedHealthcare Community & State	$0.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

COBLATION HALO WAND

Facility

$1,786.10

Hospital Charge Code	270698007
Hospital Revenue Code	272
Min. Negotiated Rate	$267.92
Max. Negotiated Rate	$267.92
Rate for Payer: Qualcare PPO/HMO/WC	$267.92

COBLATION HALO WAND

Facility

$1,786.10

Hospital Charge Code	270698007
Hospital Revenue Code	272
Min. Negotiated Rate	$50.73
Max. Negotiated Rate	$893.05
Rate for Payer: Aetna Commercial	$678.72
Rate for Payer: Aetna Medicare Advantage	$535.83
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$455.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$455.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$455.46
Rate for Payer: Cigna Commercial	$893.05
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$464.39
Rate for Payer: Oxford Commercial	$357.22
Rate for Payer: Qualcare PPO/HMO/WC	$267.92
Rate for Payer: UnitedHealthcare Commercial	$357.22
Rate for Payer: UnitedHealthcare Community & State	$56.44
Rate for Payer: Wellpoint Medicaid Managed Care	$50.73

COBLATOR II

Facility

$7,500.00

Hospital Charge Code	270655384
Hospital Revenue Code	270
Min. Negotiated Rate	$1,125.00
Max. Negotiated Rate	$1,125.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00

COBLATOR II

Facility

$7,500.00

Hospital Charge Code	270655384
Hospital Revenue Code	270
Min. Negotiated Rate	$213.00
Max. Negotiated Rate	$3,750.00
Rate for Payer: Aetna Commercial	$2,850.00
Rate for Payer: Aetna Medicare Advantage	$2,250.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,912.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,912.50
Rate for Payer: Cigna Commercial	$3,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,950.00
Rate for Payer: Oxford Commercial	$1,500.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,125.00
Rate for Payer: UnitedHealthcare Commercial	$1,500.00
Rate for Payer: UnitedHealthcare Community & State	$237.00
Rate for Payer: Wellpoint Medicaid Managed Care	$213.00

COBOLATAR PLASMA WAND

Facility

$1,352.40

Hospital Charge Code	270332590
Hospital Revenue Code	272
Min. Negotiated Rate	$202.86
Max. Negotiated Rate	$202.86
Rate for Payer: Qualcare PPO/HMO/WC	$202.86

COBOLATAR PLASMA WAND

Facility

$1,352.40

Hospital Charge Code	270332590
Hospital Revenue Code	272
Min. Negotiated Rate	$38.41
Max. Negotiated Rate	$676.20
Rate for Payer: Aetna Commercial	$513.91
Rate for Payer: Aetna Medicare Advantage	$405.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$344.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$344.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$344.86
Rate for Payer: Cigna Commercial	$676.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$351.62
Rate for Payer: Oxford Commercial	$270.48
Rate for Payer: Qualcare PPO/HMO/WC	$202.86
Rate for Payer: UnitedHealthcare Commercial	$270.48
Rate for Payer: UnitedHealthcare Community & State	$42.74
Rate for Payer: Wellpoint Medicaid Managed Care	$38.41

COBRA GLUIDE CATH 5FR 65cm C1

Facility

$71.50

Service Code	HCPCS C1887
Hospital Charge Code	270651872N
Hospital Revenue Code	278
Min. Negotiated Rate	$10.72
Max. Negotiated Rate	$17.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$10.72

COBRA GLUIDE CATH 5FR 65cm C1

Facility

$71.50

Service Code	HCPCS C1887
Hospital Charge Code	270651872N
Hospital Revenue Code	278
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$35.75
Rate for Payer: Aetna Commercial	$27.17
Rate for Payer: Aetna Medicare Advantage	$21.45
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$18.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$18.23
Rate for Payer: Cigna Commercial	$35.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$17.30
Rate for Payer: Qualcare PPO/HMO/WC	$10.72
Rate for Payer: UnitedHealthcare Community & State	$2.26
Rate for Payer: Wellpoint Medicaid Managed Care	$2.03

COBRA GLUIDE CATH 5FR 65cm C1

Facility

$1,266.25

Service Code	HCPCS C1887
Hospital Charge Code	270651872S
Hospital Revenue Code	278
Min. Negotiated Rate	$35.96
Max. Negotiated Rate	$633.12
Rate for Payer: Aetna Commercial	$481.18
Rate for Payer: Aetna Medicare Advantage	$379.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$253.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.89
Rate for Payer: Cigna Commercial	$633.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$306.43
Rate for Payer: Qualcare PPO/HMO/WC	$189.94
Rate for Payer: UnitedHealthcare Community & State	$40.01
Rate for Payer: Wellpoint Medicaid Managed Care	$35.96

COBRA GLUIDE CATH 5FR 65cm C1

Facility

$1,266.25

Service Code	HCPCS C1887
Hospital Charge Code	270651872
Hospital Revenue Code	278
Min. Negotiated Rate	$189.94
Max. Negotiated Rate	$306.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$253.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$306.43
Rate for Payer: Qualcare PPO/HMO/WC	$189.94

COBRA GLUIDE CATH 5FR 65cm C1

Facility

$1,266.25

Service Code	HCPCS C1887
Hospital Charge Code	270651872
Hospital Revenue Code	278
Min. Negotiated Rate	$35.96
Max. Negotiated Rate	$633.12
Rate for Payer: Aetna Commercial	$481.18
Rate for Payer: Aetna Medicare Advantage	$379.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$322.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$322.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$253.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$322.89
Rate for Payer: Cigna Commercial	$633.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$306.43
Rate for Payer: Qualcare PPO/HMO/WC	$189.94
Rate for Payer: UnitedHealthcare Community & State	$40.01
Rate for Payer: Wellpoint Medicaid Managed Care	$35.96

COBRA GLUIDE CATH 5FR 65cm C1

Facility

$1,266.25

Service Code	HCPCS C1887
Hospital Charge Code	270651872S
Hospital Revenue Code	278
Min. Negotiated Rate	$189.94
Max. Negotiated Rate	$306.43
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$253.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$306.43
Rate for Payer: Qualcare PPO/HMO/WC	$189.94

COCAINE

Facility

$314.00

Service Code	HCPCS 80353
Hospital Charge Code	38472209
Hospital Revenue Code	301
Min. Negotiated Rate	$47.10
Max. Negotiated Rate	$47.10
Rate for Payer: Qualcare PPO/HMO/WC	$47.10

COCAINE

Facility

$314.00

Service Code	HCPCS 80353
Hospital Charge Code	38472209
Hospital Revenue Code	301
Min. Negotiated Rate	$8.92
Max. Negotiated Rate	$157.00
Rate for Payer: Aetna Commercial	$119.32
Rate for Payer: Aetna Medicare Advantage	$94.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$80.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$80.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$80.07
Rate for Payer: Cigna Commercial	$157.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$81.64
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$47.10
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$22.05
Rate for Payer: Wellpoint Medicaid Managed Care	$8.92

COCAINE 4% TOP SOLN

Facility

$1,494.70

Service Code	NDC 527172873
Hospital Charge Code	6001333
Hospital Revenue Code	251
Min. Negotiated Rate	$42.45
Max. Negotiated Rate	$747.35
Rate for Payer: Aetna Commercial	$567.99
Rate for Payer: Aetna Medicare Advantage	$448.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$381.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$381.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$381.15
Rate for Payer: Cigna Commercial	$747.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$388.62
Rate for Payer: Oxford Commercial	$298.94
Rate for Payer: Qualcare PPO/HMO/WC	$224.21
Rate for Payer: UnitedHealthcare Commercial	$298.94
Rate for Payer: UnitedHealthcare Community & State	$47.23
Rate for Payer: Wellpoint Medicaid Managed Care	$42.45

COCAINE 4% TOP SOLN

Facility

$1,494.70

Service Code	NDC 527172873
Hospital Charge Code	6001333
Hospital Revenue Code	251
Min. Negotiated Rate	$224.21
Max. Negotiated Rate	$224.21
Rate for Payer: Qualcare PPO/HMO/WC	$224.21

COCAINE ABUSE AND DEPENDENCE

Facility

$23,819.74

Service Code	APR-DRG 7744
Min. Negotiated Rate	$23,352.69
Max. Negotiated Rate	$23,819.74
Rate for Payer: UnitedHealthcare Community & State	$23,352.69
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$23,819.74
Rate for Payer: Wellpoint Medicaid Managed Care	$23,352.69

COCAINE ABUSE AND DEPENDENCE

Facility

$9,819.46

Service Code	APR-DRG 7743
Min. Negotiated Rate	$9,626.92
Max. Negotiated Rate	$9,819.46
Rate for Payer: UnitedHealthcare Community & State	$9,626.92
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$9,819.46
Rate for Payer: Wellpoint Medicaid Managed Care	$9,626.92

COCAINE ABUSE AND DEPENDENCE

Facility

$5,425.12

Service Code	APR-DRG 7742
Min. Negotiated Rate	$5,318.75
Max. Negotiated Rate	$5,425.12
Rate for Payer: UnitedHealthcare Community & State	$5,318.75
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$5,425.12
Rate for Payer: Wellpoint Medicaid Managed Care	$5,318.75

COCAINE ABUSE AND DEPENDENCE

Facility

$4,442.09

Service Code	APR-DRG 7741
Min. Negotiated Rate	$4,354.99
Max. Negotiated Rate	$4,442.09
Rate for Payer: UnitedHealthcare Community & State	$4,354.99
Rate for Payer: Wellcare New Jersey Medicaid/Family Care	$4,442.09
Rate for Payer: Wellpoint Medicaid Managed Care	$4,354.99

Know your out-of-pocket cost for care.

All Charges