Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DERMABOND ADV SKIN ADHESIVE

Facility

$90.92

Hospital Charge Code	270653958
Hospital Revenue Code	272
Min. Negotiated Rate	$2.58
Max. Negotiated Rate	$45.46
Rate for Payer: Aetna Commercial	$34.55
Rate for Payer: Aetna Medicare Advantage	$27.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.18
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.18
Rate for Payer: Cigna Commercial	$45.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$23.64
Rate for Payer: Oxford Commercial	$18.18
Rate for Payer: Qualcare PPO/HMO/WC	$13.64
Rate for Payer: UnitedHealthcare Commercial	$18.18
Rate for Payer: UnitedHealthcare Community & State	$2.87
Rate for Payer: Wellpoint Medicaid Managed Care	$2.58

DERMABOND ADV SKIN ADHESIVE

Facility

$92.55

Hospital Charge Code	270618571N
Hospital Revenue Code	272
Min. Negotiated Rate	$13.88
Max. Negotiated Rate	$13.88
Rate for Payer: Qualcare PPO/HMO/WC	$13.88

DERMABOND ADV SKIN ADHESIVE

Facility

$90.92

Hospital Charge Code	270653958
Hospital Revenue Code	272
Min. Negotiated Rate	$13.64
Max. Negotiated Rate	$13.64
Rate for Payer: Qualcare PPO/HMO/WC	$13.64

DERMABOND ADV SKIN ADHESIVE

Facility

$92.55

Hospital Charge Code	270618571N
Hospital Revenue Code	272
Min. Negotiated Rate	$2.63
Max. Negotiated Rate	$46.27
Rate for Payer: Aetna Commercial	$35.17
Rate for Payer: Aetna Medicare Advantage	$27.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$23.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$23.60
Rate for Payer: Cigna Commercial	$46.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.06
Rate for Payer: Oxford Commercial	$18.51
Rate for Payer: Qualcare PPO/HMO/WC	$13.88
Rate for Payer: UnitedHealthcare Commercial	$18.51
Rate for Payer: UnitedHealthcare Community & State	$2.92
Rate for Payer: Wellpoint Medicaid Managed Care	$2.63

DERMABOND ADV SKIN ADHESIVE

Facility

$86.59

Hospital Charge Code	270618571
Hospital Revenue Code	272
Min. Negotiated Rate	$12.99
Max. Negotiated Rate	$12.99
Rate for Payer: Qualcare PPO/HMO/WC	$12.99

DERMABOND ADV SKIN ADHESIVE

Facility

$86.59

Hospital Charge Code	270618571
Hospital Revenue Code	272
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$43.30
Rate for Payer: Aetna Commercial	$32.90
Rate for Payer: Aetna Medicare Advantage	$25.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.08
Rate for Payer: Cigna Commercial	$43.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.51
Rate for Payer: Oxford Commercial	$17.32
Rate for Payer: Qualcare PPO/HMO/WC	$12.99
Rate for Payer: UnitedHealthcare Commercial	$17.32
Rate for Payer: UnitedHealthcare Community & State	$2.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2.46

DERMABOND ADV SKIN ADHESIVE

Facility

$86.59

Hospital Charge Code	270618571S
Hospital Revenue Code	272
Min. Negotiated Rate	$12.99
Max. Negotiated Rate	$12.99
Rate for Payer: Qualcare PPO/HMO/WC	$12.99

DERMABOND ADV SKIN ADHESIVE

Facility

$86.59

Hospital Charge Code	270618571S
Hospital Revenue Code	272
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$43.30
Rate for Payer: Aetna Commercial	$32.90
Rate for Payer: Aetna Medicare Advantage	$25.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$22.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$22.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$22.08
Rate for Payer: Cigna Commercial	$43.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$22.51
Rate for Payer: Oxford Commercial	$17.32
Rate for Payer: Qualcare PPO/HMO/WC	$12.99
Rate for Payer: UnitedHealthcare Commercial	$17.32
Rate for Payer: UnitedHealthcare Community & State	$2.74
Rate for Payer: Wellpoint Medicaid Managed Care	$2.46

DERMABOND HVD MINI 12

Facility

$55.50

Hospital Charge Code	270677258
Hospital Revenue Code	272
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$27.75
Rate for Payer: Aetna Commercial	$21.09
Rate for Payer: Aetna Medicare Advantage	$16.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.15
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.15
Rate for Payer: Cigna Commercial	$27.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.43
Rate for Payer: Oxford Commercial	$11.10
Rate for Payer: Qualcare PPO/HMO/WC	$8.32
Rate for Payer: UnitedHealthcare Commercial	$11.10
Rate for Payer: UnitedHealthcare Community & State	$1.75
Rate for Payer: Wellpoint Medicaid Managed Care	$1.58

DERMABOND HVD MINI 12

Facility

$55.50

Hospital Charge Code	270677258
Hospital Revenue Code	272
Min. Negotiated Rate	$8.32
Max. Negotiated Rate	$8.32
Rate for Payer: Qualcare PPO/HMO/WC	$8.32

DERMABOND PRINEO Sys 22cm

Facility

$382.50

Hospital Charge Code	270674023
Hospital Revenue Code	272
Min. Negotiated Rate	$10.86
Max. Negotiated Rate	$191.25
Rate for Payer: Aetna Commercial	$145.35
Rate for Payer: Aetna Medicare Advantage	$114.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$97.54
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$97.54
Rate for Payer: Cigna Commercial	$191.25
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$99.45
Rate for Payer: Oxford Commercial	$76.50
Rate for Payer: Qualcare PPO/HMO/WC	$57.38
Rate for Payer: UnitedHealthcare Commercial	$76.50
Rate for Payer: UnitedHealthcare Community & State	$12.09
Rate for Payer: Wellpoint Medicaid Managed Care	$10.86

DERMABOND PRINEO Sys 22cm

Facility

$382.50

Hospital Charge Code	270674023
Hospital Revenue Code	272
Min. Negotiated Rate	$57.38
Max. Negotiated Rate	$57.38
Rate for Payer: Qualcare PPO/HMO/WC	$57.38

DERMACARRIER 1.5 TO 1

Facility

$2,947.50

Hospital Charge Code	270664759
Hospital Revenue Code	270
Min. Negotiated Rate	$83.71
Max. Negotiated Rate	$1,473.75
Rate for Payer: Aetna Commercial	$1,120.05
Rate for Payer: Aetna Medicare Advantage	$884.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$751.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$751.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$751.61
Rate for Payer: Cigna Commercial	$1,473.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$766.35
Rate for Payer: Oxford Commercial	$589.50
Rate for Payer: Qualcare PPO/HMO/WC	$442.12
Rate for Payer: UnitedHealthcare Commercial	$589.50
Rate for Payer: UnitedHealthcare Community & State	$93.14
Rate for Payer: Wellpoint Medicaid Managed Care	$83.71

DERMACARRIER 1.5 TO 1

Facility

$2,947.50

Hospital Charge Code	270664759
Hospital Revenue Code	270
Min. Negotiated Rate	$442.12
Max. Negotiated Rate	$442.12
Rate for Payer: Qualcare PPO/HMO/WC	$442.12

DERMACARRIER II SKIN GRAFT

Facility

$171.00

Hospital Charge Code	270331680
Hospital Revenue Code	272
Min. Negotiated Rate	$4.86
Max. Negotiated Rate	$85.50
Rate for Payer: Aetna Commercial	$64.98
Rate for Payer: Aetna Medicare Advantage	$51.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.60
Rate for Payer: Cigna Commercial	$85.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.46
Rate for Payer: Oxford Commercial	$34.20
Rate for Payer: Qualcare PPO/HMO/WC	$25.65
Rate for Payer: UnitedHealthcare Commercial	$34.20
Rate for Payer: UnitedHealthcare Community & State	$5.40
Rate for Payer: Wellpoint Medicaid Managed Care	$4.86

DERMACARRIER II SKIN GRAFT

Facility

$171.00

Hospital Charge Code	270331680
Hospital Revenue Code	272
Min. Negotiated Rate	$25.65
Max. Negotiated Rate	$25.65
Rate for Payer: Qualcare PPO/HMO/WC	$25.65

DERMACARRIERS II SKIN GRAFT

Facility

$174.00

Hospital Charge Code	270600394
Hospital Revenue Code	272
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.24
Rate for Payer: Oxford Commercial	$34.80
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$34.80
Rate for Payer: UnitedHealthcare Community & State	$5.50
Rate for Payer: Wellpoint Medicaid Managed Care	$4.94

DERMACARRIERS II SKIN GRAFT

Facility

$174.00

Hospital Charge Code	270600394
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

DERMACARRIER SKIN GRAFT 3 TO 1

Facility

$174.00

Hospital Charge Code	270331700
Hospital Revenue Code	272
Min. Negotiated Rate	$4.94
Max. Negotiated Rate	$87.00
Rate for Payer: Aetna Commercial	$66.12
Rate for Payer: Aetna Medicare Advantage	$52.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$44.37
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$44.37
Rate for Payer: Cigna Commercial	$87.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$45.24
Rate for Payer: Oxford Commercial	$34.80
Rate for Payer: Qualcare PPO/HMO/WC	$26.10
Rate for Payer: UnitedHealthcare Commercial	$34.80
Rate for Payer: UnitedHealthcare Community & State	$5.50
Rate for Payer: Wellpoint Medicaid Managed Care	$4.94

DERMACARRIER SKIN GRAFT 3 TO 1

Facility

$174.00

Hospital Charge Code	270331700
Hospital Revenue Code	272
Min. Negotiated Rate	$26.10
Max. Negotiated Rate	$26.10
Rate for Payer: Qualcare PPO/HMO/WC	$26.10

DERMACELL 4X4 CM

Facility

$6,480.00

Hospital Charge Code	270657236
Hospital Revenue Code	636
Min. Negotiated Rate	$972.00
Max. Negotiated Rate	$1,568.16
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.16
Rate for Payer: Qualcare PPO/HMO/WC	$972.00

DERMACELL 4X4 CM

Facility

$6,480.00

Hospital Charge Code	270657236
Hospital Revenue Code	636
Min. Negotiated Rate	$184.03
Max. Negotiated Rate	$3,240.00
Rate for Payer: Aetna Commercial	$2,462.40
Rate for Payer: Aetna Medicare Advantage	$1,944.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,652.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,652.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,652.40
Rate for Payer: Cigna Commercial	$3,240.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,568.16
Rate for Payer: Qualcare PPO/HMO/WC	$972.00
Rate for Payer: UnitedHealthcare Community & State	$204.77
Rate for Payer: Wellpoint Medicaid Managed Care	$184.03

DERMACELL 4X4 CM/SQ CM JW

Facility

$405.00

Hospital Charge Code	270657236W
Hospital Revenue Code	636
Min. Negotiated Rate	$11.50
Max. Negotiated Rate	$202.50
Rate for Payer: Aetna Commercial	$153.90
Rate for Payer: Aetna Medicare Advantage	$121.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$103.28
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$103.28
Rate for Payer: Cigna Commercial	$202.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75
Rate for Payer: UnitedHealthcare Community & State	$12.80
Rate for Payer: Wellpoint Medicaid Managed Care	$11.50

DERMACELL 4X4 CM/SQ CM JW

Facility

$405.00

Hospital Charge Code	270657236W
Hospital Revenue Code	636
Min. Negotiated Rate	$60.75
Max. Negotiated Rate	$98.01
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$98.01
Rate for Payer: Qualcare PPO/HMO/WC	$60.75

DERMACELL GRAFT

Facility

$7,200.00

Hospital Charge Code	270339527
Hospital Revenue Code	636
Min. Negotiated Rate	$1,080.00
Max. Negotiated Rate	$1,742.40
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,742.40
Rate for Payer: Qualcare PPO/HMO/WC	$1,080.00

Know your out-of-pocket cost for care.

All Charges