Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DRESSG 2x2 STER BX

Facility

$11.25

Hospital Charge Code	270350065
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

DRESSG 2x2 STER BX

Facility

$11.25

Hospital Charge Code	270350065
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

DRESSG 4x4 STER BOX

Facility

$5.00

Hospital Charge Code	270350100
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$0.75
Rate for Payer: Qualcare PPO/HMO/WC	$0.75

DRESSG 4x4 STER BOX

Facility

$5.00

Hospital Charge Code	270350100
Hospital Revenue Code	272
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.50
Rate for Payer: Aetna Commercial	$1.90
Rate for Payer: Aetna Medicare Advantage	$1.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.27
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.27
Rate for Payer: Cigna Commercial	$2.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.30
Rate for Payer: Oxford Commercial	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$0.75
Rate for Payer: UnitedHealthcare Commercial	$1.00
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

DRESSG ACTICOAT 4X5 SN20141

Facility

$95.83

Hospital Charge Code	270627497
Hospital Revenue Code	272
Min. Negotiated Rate	$2.72
Max. Negotiated Rate	$47.91
Rate for Payer: Aetna Commercial	$36.42
Rate for Payer: Aetna Medicare Advantage	$28.75
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.44
Rate for Payer: Cigna Commercial	$47.91
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.92
Rate for Payer: Oxford Commercial	$19.17
Rate for Payer: Qualcare PPO/HMO/WC	$14.37
Rate for Payer: UnitedHealthcare Commercial	$19.17
Rate for Payer: UnitedHealthcare Community & State	$3.03
Rate for Payer: Wellpoint Medicaid Managed Care	$2.72

DRESSG ACTICOAT 4X5 SN20141

Facility

$95.83

Hospital Charge Code	270627497
Hospital Revenue Code	272
Min. Negotiated Rate	$14.37
Max. Negotiated Rate	$14.37
Rate for Payer: Qualcare PPO/HMO/WC	$14.37

DRESSG ADAPTIC ST 3X8

Facility

$6.70

Hospital Charge Code	270350190
Hospital Revenue Code	272
Min. Negotiated Rate	$1.00
Max. Negotiated Rate	$1.00
Rate for Payer: Qualcare PPO/HMO/WC	$1.00

DRESSG ADAPTIC ST 3X8

Facility

$6.70

Hospital Charge Code	270350190
Hospital Revenue Code	272
Min. Negotiated Rate	$0.19
Max. Negotiated Rate	$3.35
Rate for Payer: Aetna Commercial	$2.55
Rate for Payer: Aetna Medicare Advantage	$2.01
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.71
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.71
Rate for Payer: Cigna Commercial	$3.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.74
Rate for Payer: Oxford Commercial	$1.34
Rate for Payer: Qualcare PPO/HMO/WC	$1.00
Rate for Payer: UnitedHealthcare Commercial	$1.34
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.19

DRESSG BANDAID 8X6

Facility

$11.25

Hospital Charge Code	270350155
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

DRESSG BANDAID 8X6

Facility

$11.25

Hospital Charge Code	270350155
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

DRESSG OPTFOAM 4X4

Facility

$13.55

Hospital Charge Code	270350275W
Hospital Revenue Code	272
Min. Negotiated Rate	$2.03
Max. Negotiated Rate	$2.03
Rate for Payer: Qualcare PPO/HMO/WC	$2.03

DRESSG OPTFOAM 4X4

Facility

$13.55

Hospital Charge Code	270350275W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.38
Max. Negotiated Rate	$6.78
Rate for Payer: Aetna Commercial	$5.15
Rate for Payer: Aetna Medicare Advantage	$4.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.46
Rate for Payer: Cigna Commercial	$6.78
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.52
Rate for Payer: Oxford Commercial	$2.71
Rate for Payer: Qualcare PPO/HMO/WC	$2.03
Rate for Payer: UnitedHealthcare Commercial	$2.71
Rate for Payer: UnitedHealthcare Community & State	$0.43
Rate for Payer: Wellpoint Medicaid Managed Care	$0.38

DRESSG OPTIFOAM SAC 6x5.6

Facility

$35.92

Hospital Charge Code	270641299
Hospital Revenue Code	272
Min. Negotiated Rate	$5.39
Max. Negotiated Rate	$5.39
Rate for Payer: Qualcare PPO/HMO/WC	$5.39

DRESSG OPTIFOAM SAC 6x5.6

Facility

$35.92

Hospital Charge Code	270641299
Hospital Revenue Code	272
Min. Negotiated Rate	$1.02
Max. Negotiated Rate	$17.96
Rate for Payer: Aetna Commercial	$13.65
Rate for Payer: Aetna Medicare Advantage	$10.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.16
Rate for Payer: Cigna Commercial	$17.96
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.34
Rate for Payer: Oxford Commercial	$7.18
Rate for Payer: Qualcare PPO/HMO/WC	$5.39
Rate for Payer: UnitedHealthcare Commercial	$7.18
Rate for Payer: UnitedHealthcare Community & State	$1.14
Rate for Payer: Wellpoint Medicaid Managed Care	$1.02

DRESSG PRECUT 3 7/8 / 2 7/8

Facility

$11.25

Hospital Charge Code	270350260
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

DRESSG PRECUT 3 7/8 / 2 7/8

Facility

$11.25

Hospital Charge Code	270350260
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

DRESSG PRECUT 5 7/8 / 11

Facility

$19.25

Hospital Charge Code	270350270
Hospital Revenue Code	272
Min. Negotiated Rate	$2.89
Max. Negotiated Rate	$2.89
Rate for Payer: Qualcare PPO/HMO/WC	$2.89

DRESSG PRECUT 5 7/8 / 11

Facility

$19.25

Hospital Charge Code	270350270
Hospital Revenue Code	272
Min. Negotiated Rate	$0.55
Max. Negotiated Rate	$9.62
Rate for Payer: Aetna Commercial	$7.32
Rate for Payer: Aetna Medicare Advantage	$5.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.91
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.91
Rate for Payer: Cigna Commercial	$9.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5.00
Rate for Payer: Oxford Commercial	$3.85
Rate for Payer: Qualcare PPO/HMO/WC	$2.89
Rate for Payer: UnitedHealthcare Commercial	$3.85
Rate for Payer: UnitedHealthcare Community & State	$0.61
Rate for Payer: Wellpoint Medicaid Managed Care	$0.55

DRESSG PRECUT 5 7/8 / 5 7/8

Facility

$11.25

Hospital Charge Code	270350265
Hospital Revenue Code	272
Min. Negotiated Rate	$1.69
Max. Negotiated Rate	$1.69
Rate for Payer: Qualcare PPO/HMO/WC	$1.69

DRESSG PRECUT 5 7/8 / 5 7/8

Facility

$11.25

Hospital Charge Code	270350265
Hospital Revenue Code	272
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$5.62
Rate for Payer: Aetna Commercial	$4.28
Rate for Payer: Aetna Medicare Advantage	$3.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.87
Rate for Payer: Cigna Commercial	$5.62
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.92
Rate for Payer: Oxford Commercial	$2.25
Rate for Payer: Qualcare PPO/HMO/WC	$1.69
Rate for Payer: UnitedHealthcare Commercial	$2.25
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

DRESSG SALINE STER 4X8

Facility

$6.92

Hospital Charge Code	270350020
Hospital Revenue Code	272
Min. Negotiated Rate	$0.20
Max. Negotiated Rate	$3.46
Rate for Payer: Aetna Commercial	$2.63
Rate for Payer: Aetna Medicare Advantage	$2.08
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.76
Rate for Payer: Cigna Commercial	$3.46
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.80
Rate for Payer: Oxford Commercial	$1.38
Rate for Payer: Qualcare PPO/HMO/WC	$1.04
Rate for Payer: UnitedHealthcare Commercial	$1.38
Rate for Payer: UnitedHealthcare Community & State	$0.22
Rate for Payer: Wellpoint Medicaid Managed Care	$0.20

DRESSG SALINE STER 4X8

Facility

$6.92

Hospital Charge Code	270350020
Hospital Revenue Code	272
Min. Negotiated Rate	$1.04
Max. Negotiated Rate	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$1.04

DRESSG TEGAD 4 / 4 3/4

Facility

$8.22

Hospital Charge Code	270350210
Hospital Revenue Code	270
Min. Negotiated Rate	$1.23
Max. Negotiated Rate	$1.23
Rate for Payer: Qualcare PPO/HMO/WC	$1.23

DRESSG TEGAD 4 / 4 3/4

Facility

$8.22

Hospital Charge Code	270350210
Hospital Revenue Code	270
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$4.11
Rate for Payer: Aetna Commercial	$3.12
Rate for Payer: Aetna Medicare Advantage	$2.47
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.10
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.10
Rate for Payer: Cigna Commercial	$4.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.14
Rate for Payer: Oxford Commercial	$1.64
Rate for Payer: Qualcare PPO/HMO/WC	$1.23
Rate for Payer: UnitedHealthcare Commercial	$1.64
Rate for Payer: UnitedHealthcare Community & State	$0.26
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

DRESSG TEGAD 4X10

Facility

$5.86

Hospital Charge Code	270350215
Hospital Revenue Code	272
Min. Negotiated Rate	$0.88
Max. Negotiated Rate	$0.88
Rate for Payer: Qualcare PPO/HMO/WC	$0.88

Know your out-of-pocket cost for care.

All Charges