Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

CORTISPORIN OTIC/10ML

Facility

$674.56

Service Code	NDC 61314064610
Hospital Charge Code	60632752
Hospital Revenue Code	250
Min. Negotiated Rate	$101.18
Max. Negotiated Rate	$101.18
Rate for Payer: Qualcare PPO/HMO/WC	$101.18

CORTISPORIN OTIC/10ML

Facility

$674.56

Service Code	NDC 61314064610
Hospital Charge Code	60632752
Hospital Revenue Code	250
Min. Negotiated Rate	$19.16
Max. Negotiated Rate	$337.28
Rate for Payer: Aetna Commercial	$256.33
Rate for Payer: Aetna Medicare Advantage	$202.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.01
Rate for Payer: Cigna Commercial	$337.28
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$175.39
Rate for Payer: Oxford Commercial	$134.91
Rate for Payer: Qualcare PPO/HMO/WC	$101.18
Rate for Payer: UnitedHealthcare Commercial	$134.91
Rate for Payer: UnitedHealthcare Community & State	$21.32
Rate for Payer: Wellpoint Medicaid Managed Care	$19.16

CORUS PCSS IMPLANT 4MM

Facility

$19,000.00

Hospital Charge Code	270703456
Hospital Revenue Code	278
Min. Negotiated Rate	$539.60
Max. Negotiated Rate	$9,500.00
Rate for Payer: Aetna Commercial	$7,220.00
Rate for Payer: Aetna Medicare Advantage	$5,700.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4,845.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4,845.00
Rate for Payer: Cigna Commercial	$9,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00
Rate for Payer: UnitedHealthcare Community & State	$600.40
Rate for Payer: Wellpoint Medicaid Managed Care	$539.60

CORUS PCSS IMPLANT 4MM

Facility

$19,000.00

Hospital Charge Code	270703456
Hospital Revenue Code	278
Min. Negotiated Rate	$2,850.00
Max. Negotiated Rate	$4,598.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,800.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,598.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,850.00

CORUS PCSS L1 4MM

Facility

$41,500.00

Hospital Charge Code	270703455
Hospital Revenue Code	278
Min. Negotiated Rate	$1,178.60
Max. Negotiated Rate	$20,750.00
Rate for Payer: Aetna Commercial	$15,770.00
Rate for Payer: Aetna Medicare Advantage	$12,450.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10,582.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10,582.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10,582.50
Rate for Payer: Cigna Commercial	$20,750.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,043.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,225.00
Rate for Payer: UnitedHealthcare Community & State	$1,311.40
Rate for Payer: Wellpoint Medicaid Managed Care	$1,178.60

CORUS PCSS L1 4MM

Facility

$41,500.00

Hospital Charge Code	270703455
Hospital Revenue Code	278
Min. Negotiated Rate	$6,225.00
Max. Negotiated Rate	$10,043.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$8,300.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10,043.00
Rate for Payer: Qualcare PPO/HMO/WC	$6,225.00

COSYNTROPIN 0.25 MG PDS

Facility

$856.93

Service Code	HCPCS J0834
Hospital Charge Code	6001382
Hospital Revenue Code	636
Min. Negotiated Rate	$128.54
Max. Negotiated Rate	$207.38
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.38
Rate for Payer: Qualcare PPO/HMO/WC	$128.54

COSYNTROPIN 0.25 MG PDS

Facility

$856.93

Service Code	HCPCS J0834
Hospital Charge Code	6001382
Hospital Revenue Code	636
Min. Negotiated Rate	$24.34
Max. Negotiated Rate	$428.46
Rate for Payer: Aetna Commercial	$325.63
Rate for Payer: Aetna Medicare Advantage	$257.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$218.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$218.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$218.52
Rate for Payer: Cigna Commercial	$428.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$207.38
Rate for Payer: Qualcare PPO/HMO/WC	$128.54
Rate for Payer: UnitedHealthcare Community & State	$27.08
Rate for Payer: Wellpoint Medicaid Managed Care	$24.34

COTININE, URINE

Facility

$333.00

Service Code	HCPCS 86022
Hospital Charge Code	38473083
Hospital Revenue Code	302
Min. Negotiated Rate	$9.46
Max. Negotiated Rate	$166.50
Rate for Payer: Aetna Commercial	$49.97
Rate for Payer: Aetna Medicare Advantage	$59.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$66.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$66.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$18.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$14.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$66.64
Rate for Payer: Cigna Commercial	$166.50
Rate for Payer: Cigna Medicare Advantage	$18.37
Rate for Payer: Clover Medicare Advantage	$17.45
Rate for Payer: EmblemHealth Commercial	$55.11
Rate for Payer: Humana Medicare Advantage	$18.92
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$18.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$86.58
Rate for Payer: Oxford Commercial	$156.00
Rate for Payer: Qualcare PPO/HMO/WC	$49.95
Rate for Payer: UnitedHealthcare Commercial	$156.00
Rate for Payer: UnitedHealthcare Community & State	$14.70
Rate for Payer: UnitedHealthcare Medicare Advantage	$18.37
Rate for Payer: Wellcare Medicare Advantage	$18.37
Rate for Payer: Wellpoint Medicaid Managed Care	$9.46

COTININE, URINE

Facility

$333.00

Service Code	HCPCS 86022
Hospital Charge Code	38473083
Hospital Revenue Code	302
Min. Negotiated Rate	$49.95
Max. Negotiated Rate	$49.95
Rate for Payer: Qualcare PPO/HMO/WC	$49.95

COTTON ALLOG WEDGE 6X24X14MM

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270671557
Hospital Revenue Code	278
Min. Negotiated Rate	$312.40
Max. Negotiated Rate	$5,500.00
Rate for Payer: Aetna Commercial	$4,180.00
Rate for Payer: Aetna Medicare Advantage	$3,300.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,805.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,805.00
Rate for Payer: Cigna Commercial	$5,500.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00
Rate for Payer: UnitedHealthcare Community & State	$347.60
Rate for Payer: Wellpoint Medicaid Managed Care	$312.40

COTTON ALLOG WEDGE 6X24X14MM

Facility

$11,000.00

Service Code	HCPCS C1889
Hospital Charge Code	270671557
Hospital Revenue Code	278
Min. Negotiated Rate	$1,650.00
Max. Negotiated Rate	$2,662.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,200.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,662.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,650.00

COTTON-LEUNG STENT ONLY 7FR

Facility

$253.00

Hospital Charge Code	270332242
Hospital Revenue Code	278
Min. Negotiated Rate	$37.95
Max. Negotiated Rate	$61.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.23
Rate for Payer: Qualcare PPO/HMO/WC	$37.95

COTTON-LEUNG STENT ONLY 7FR

Facility

$253.00

Hospital Charge Code	270332242
Hospital Revenue Code	278
Min. Negotiated Rate	$7.19
Max. Negotiated Rate	$126.50
Rate for Payer: Aetna Commercial	$96.14
Rate for Payer: Aetna Medicare Advantage	$75.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$64.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$50.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$64.52
Rate for Payer: Cigna Commercial	$126.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$61.23
Rate for Payer: Qualcare PPO/HMO/WC	$37.95
Rate for Payer: UnitedHealthcare Community & State	$7.99
Rate for Payer: Wellpoint Medicaid Managed Care	$7.19

COTTON WEDGE 15X20X8MM

Facility

$14,490.00

Hospital Charge Code	270700419
Hospital Revenue Code	278
Min. Negotiated Rate	$411.52
Max. Negotiated Rate	$7,245.00
Rate for Payer: Aetna Commercial	$5,506.20
Rate for Payer: Aetna Medicare Advantage	$4,347.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3,694.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3,694.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,898.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3,694.95
Rate for Payer: Cigna Commercial	$7,245.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,506.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,173.50
Rate for Payer: UnitedHealthcare Community & State	$457.88
Rate for Payer: Wellpoint Medicaid Managed Care	$411.52

COTTON WEDGE 15X20X8MM

Facility

$14,490.00

Hospital Charge Code	270700419
Hospital Revenue Code	278
Min. Negotiated Rate	$2,173.50
Max. Negotiated Rate	$3,506.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,898.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,506.58
Rate for Payer: Qualcare PPO/HMO/WC	$2,173.50

COTTON WEDGE 8MM

Facility

$4,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270674212
Hospital Revenue Code	278
Min. Negotiated Rate	$741.00
Max. Negotiated Rate	$1,195.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$988.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.48
Rate for Payer: Qualcare PPO/HMO/WC	$741.00

COTTON WEDGE 8MM

Facility

$4,940.00

Service Code	HCPCS C1713
Hospital Charge Code	270674212
Hospital Revenue Code	278
Min. Negotiated Rate	$140.30
Max. Negotiated Rate	$2,470.00
Rate for Payer: Aetna Commercial	$1,877.20
Rate for Payer: Aetna Medicare Advantage	$1,482.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,259.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,259.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$988.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,259.70
Rate for Payer: Cigna Commercial	$2,470.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,195.48
Rate for Payer: Qualcare PPO/HMO/WC	$741.00
Rate for Payer: UnitedHealthcare Community & State	$156.10
Rate for Payer: Wellpoint Medicaid Managed Care	$140.30

COTTON WEDGE BIO 20X14X10X6.5

Facility

$10,136.50

Service Code	HCPCS C1716
Hospital Charge Code	270702334
Hospital Revenue Code	278
Min. Negotiated Rate	$287.88
Max. Negotiated Rate	$2,453.03
Rate for Payer: Aetna Commercial	$1,624.38
Rate for Payer: Aetna Medicare Advantage	$1,934.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2,166.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2,166.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$597.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,027.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2,166.34
Rate for Payer: Cigna Commercial	$1,197.08
Rate for Payer: Cigna Medicare Advantage	$597.20
Rate for Payer: Clover Medicare Advantage	$567.34
Rate for Payer: EmblemHealth Commercial	$1,791.60
Rate for Payer: Humana Medicare Advantage	$615.12
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$597.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,453.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,520.47
Rate for Payer: UnitedHealthcare Community & State	$320.31
Rate for Payer: UnitedHealthcare Medicare Advantage	$597.20
Rate for Payer: Wellcare Medicare Advantage	$597.20
Rate for Payer: Wellpoint Medicaid Managed Care	$287.88

COTTON WEDGE BIO 20X14X10X6.5

Facility

$10,136.50

Service Code	HCPCS C1716
Hospital Charge Code	270702334
Hospital Revenue Code	278
Min. Negotiated Rate	$1,520.47
Max. Negotiated Rate	$2,453.03
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$2,027.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,453.03
Rate for Payer: Qualcare PPO/HMO/WC	$1,520.47

COUMADIN 4MG

Facility

$14.94

Service Code	NDC 56016870
Hospital Charge Code	60635727
Hospital Revenue Code	250
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$2.24
Rate for Payer: Qualcare PPO/HMO/WC	$2.24

COUMADIN 4MG

Facility

$14.94

Service Code	NDC 56016870
Hospital Charge Code	60635727
Hospital Revenue Code	250
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$7.47
Rate for Payer: Aetna Commercial	$5.68
Rate for Payer: Aetna Medicare Advantage	$4.48
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.81
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.81
Rate for Payer: Cigna Commercial	$7.47
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.88
Rate for Payer: Oxford Commercial	$2.99
Rate for Payer: Qualcare PPO/HMO/WC	$2.24
Rate for Payer: UnitedHealthcare Commercial	$2.99
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

COUNSELING/RISK FACTOR 15 MINS

Facility

$134.00

Service Code	HCPCS 99401
Hospital Charge Code	9200095
Hospital Revenue Code	761
Min. Negotiated Rate	$3.81
Max. Negotiated Rate	$67.00
Rate for Payer: Aetna Commercial	$50.92
Rate for Payer: Aetna Medicare Advantage	$40.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$34.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$34.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$34.17
Rate for Payer: Cigna Commercial	$67.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$34.84
Rate for Payer: Oxford Commercial	$26.80
Rate for Payer: Qualcare PPO/HMO/WC	$20.10
Rate for Payer: UnitedHealthcare Commercial	$26.80
Rate for Payer: UnitedHealthcare Community & State	$4.23
Rate for Payer: Wellpoint Medicaid Managed Care	$3.81

COUNSELING/RISK FACTOR 15 MINS

Facility

$134.00

Service Code	HCPCS 99401
Hospital Charge Code	9200095
Hospital Revenue Code	761
Min. Negotiated Rate	$20.10
Max. Negotiated Rate	$20.10
Rate for Payer: Qualcare PPO/HMO/WC	$20.10

COUNTERSINK

Facility

$1,545.00

Hospital Charge Code	270688016
Hospital Revenue Code	272
Min. Negotiated Rate	$43.88
Max. Negotiated Rate	$772.50
Rate for Payer: Aetna Commercial	$587.10
Rate for Payer: Aetna Medicare Advantage	$463.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$393.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$393.98
Rate for Payer: Cigna Commercial	$772.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$401.70
Rate for Payer: Oxford Commercial	$309.00
Rate for Payer: Qualcare PPO/HMO/WC	$231.75
Rate for Payer: UnitedHealthcare Commercial	$309.00
Rate for Payer: UnitedHealthcare Community & State	$48.82
Rate for Payer: Wellpoint Medicaid Managed Care	$43.88

Know your out-of-pocket cost for care.

All Charges