Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DRESSING ALLDRESS 4 x 4 IN

Facility

$5.19

Hospital Charge Code	270685409
Hospital Revenue Code	272
Min. Negotiated Rate	$0.78
Max. Negotiated Rate	$0.78
Rate for Payer: Qualcare PPO/HMO/WC	$0.78

DRESSING ALLDRESS 4 x 4 IN

Facility

$5.19

Hospital Charge Code	270685409
Hospital Revenue Code	272
Min. Negotiated Rate	$0.15
Max. Negotiated Rate	$2.60
Rate for Payer: Aetna Commercial	$1.97
Rate for Payer: Aetna Medicare Advantage	$1.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.32
Rate for Payer: Cigna Commercial	$2.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.35
Rate for Payer: Oxford Commercial	$1.04
Rate for Payer: Qualcare PPO/HMO/WC	$0.78
Rate for Payer: UnitedHealthcare Commercial	$1.04
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.15

DRESSING ALLDRESS 6 x 6 IN

Facility

$6.48

Hospital Charge Code	270685410
Hospital Revenue Code	272
Min. Negotiated Rate	$0.97
Max. Negotiated Rate	$0.97
Rate for Payer: Qualcare PPO/HMO/WC	$0.97

DRESSING ALLDRESS 6 x 6 IN

Facility

$6.48

Hospital Charge Code	270685410
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.24
Rate for Payer: Aetna Commercial	$2.46
Rate for Payer: Aetna Medicare Advantage	$1.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.65
Rate for Payer: Cigna Commercial	$3.24
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.68
Rate for Payer: Oxford Commercial	$1.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.97
Rate for Payer: UnitedHealthcare Commercial	$1.30
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

DRESSING ALLEVYN+ 5X5

Facility

$33.90

Hospital Charge Code	270650198
Hospital Revenue Code	270
Min. Negotiated Rate	$0.96
Max. Negotiated Rate	$16.95
Rate for Payer: Aetna Commercial	$12.88
Rate for Payer: Aetna Medicare Advantage	$10.17
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.64
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.64
Rate for Payer: Cigna Commercial	$16.95
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.81
Rate for Payer: Oxford Commercial	$6.78
Rate for Payer: Qualcare PPO/HMO/WC	$5.08
Rate for Payer: UnitedHealthcare Commercial	$6.78
Rate for Payer: UnitedHealthcare Community & State	$1.07
Rate for Payer: Wellpoint Medicaid Managed Care	$0.96

DRESSING ALLEVYN+ 5X5

Facility

$33.90

Hospital Charge Code	270650198
Hospital Revenue Code	270
Min. Negotiated Rate	$5.08
Max. Negotiated Rate	$5.08
Rate for Payer: Qualcare PPO/HMO/WC	$5.08

DRESSING ALLEVYN ADHESIVE 3x3

Facility

$11.38

Hospital Charge Code	270649912
Hospital Revenue Code	270
Min. Negotiated Rate	$0.32
Max. Negotiated Rate	$5.69
Rate for Payer: Aetna Commercial	$4.32
Rate for Payer: Aetna Medicare Advantage	$3.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.90
Rate for Payer: Cigna Commercial	$5.69
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.96
Rate for Payer: Oxford Commercial	$2.28
Rate for Payer: Qualcare PPO/HMO/WC	$1.71
Rate for Payer: UnitedHealthcare Commercial	$2.28
Rate for Payer: UnitedHealthcare Community & State	$0.36
Rate for Payer: Wellpoint Medicaid Managed Care	$0.32

DRESSING ALLEVYN ADHESIVE 3x3

Facility

$11.38

Hospital Charge Code	270649912
Hospital Revenue Code	270
Min. Negotiated Rate	$1.71
Max. Negotiated Rate	$1.71
Rate for Payer: Qualcare PPO/HMO/WC	$1.71

DRESSING ALLEVYN ADHESIVE 5x5

Facility

$14.81

Hospital Charge Code	270649913
Hospital Revenue Code	270
Min. Negotiated Rate	$2.22
Max. Negotiated Rate	$2.22
Rate for Payer: Qualcare PPO/HMO/WC	$2.22

DRESSING ALLEVYN ADHESIVE 5x5

Facility

$14.81

Hospital Charge Code	270649913
Hospital Revenue Code	270
Min. Negotiated Rate	$0.42
Max. Negotiated Rate	$7.41
Rate for Payer: Aetna Commercial	$5.63
Rate for Payer: Aetna Medicare Advantage	$4.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.78
Rate for Payer: Cigna Commercial	$7.41
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.85
Rate for Payer: Oxford Commercial	$2.96
Rate for Payer: Qualcare PPO/HMO/WC	$2.22
Rate for Payer: UnitedHealthcare Commercial	$2.96
Rate for Payer: UnitedHealthcare Community & State	$0.47
Rate for Payer: Wellpoint Medicaid Managed Care	$0.42

DRESSING AQUACEL

Facility

$26.60

Hospital Charge Code	270703762
Hospital Revenue Code	279
Min. Negotiated Rate	$3.99
Max. Negotiated Rate	$3.99
Rate for Payer: Qualcare PPO/HMO/WC	$3.99

DRESSING AQUACEL

Facility

$26.60

Hospital Charge Code	270703762
Hospital Revenue Code	279
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$13.30
Rate for Payer: Aetna Commercial	$10.11
Rate for Payer: Aetna Medicare Advantage	$7.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.78
Rate for Payer: Cigna Commercial	$13.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.92
Rate for Payer: Oxford Commercial	$5.32
Rate for Payer: Qualcare PPO/HMO/WC	$3.99
Rate for Payer: UnitedHealthcare Commercial	$5.32
Rate for Payer: UnitedHealthcare Community & State	$0.84
Rate for Payer: Wellpoint Medicaid Managed Care	$0.76

DRESSING AQUACEL 2x2

Facility

$26.24

Hospital Charge Code	270677555
Hospital Revenue Code	272
Min. Negotiated Rate	$3.94
Max. Negotiated Rate	$3.94
Rate for Payer: Qualcare PPO/HMO/WC	$3.94

DRESSING AQUACEL 2x2

Facility

$26.24

Hospital Charge Code	270677555
Hospital Revenue Code	272
Min. Negotiated Rate	$0.75
Max. Negotiated Rate	$13.12
Rate for Payer: Aetna Commercial	$9.97
Rate for Payer: Aetna Medicare Advantage	$7.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.69
Rate for Payer: Cigna Commercial	$13.12
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.82
Rate for Payer: Oxford Commercial	$5.25
Rate for Payer: Qualcare PPO/HMO/WC	$3.94
Rate for Payer: UnitedHealthcare Commercial	$5.25
Rate for Payer: UnitedHealthcare Community & State	$0.83
Rate for Payer: Wellpoint Medicaid Managed Care	$0.75

DRESSING AQUACEL 4x4 177902

Facility

$18.69

Hospital Charge Code	270350285
Hospital Revenue Code	272
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$9.35
Rate for Payer: Aetna Commercial	$7.10
Rate for Payer: Aetna Medicare Advantage	$5.61
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.77
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.77
Rate for Payer: Cigna Commercial	$9.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.86
Rate for Payer: Oxford Commercial	$3.74
Rate for Payer: Qualcare PPO/HMO/WC	$2.80
Rate for Payer: UnitedHealthcare Commercial	$3.74
Rate for Payer: UnitedHealthcare Community & State	$0.59
Rate for Payer: Wellpoint Medicaid Managed Care	$0.53

DRESSING AQUACEL 4x4 177902

Facility

$18.69

Hospital Charge Code	270350285
Hospital Revenue Code	272
Min. Negotiated Rate	$2.80
Max. Negotiated Rate	$2.80
Rate for Payer: Qualcare PPO/HMO/WC	$2.80

DRESSING AQUACEL 4X4.7

Facility

$50.54

Hospital Charge Code	270649157
Hospital Revenue Code	272
Min. Negotiated Rate	$7.58
Max. Negotiated Rate	$7.58
Rate for Payer: Qualcare PPO/HMO/WC	$7.58

DRESSING AQUACEL 4X4.7

Facility

$50.54

Hospital Charge Code	270649157
Hospital Revenue Code	272
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$25.27
Rate for Payer: Aetna Commercial	$19.21
Rate for Payer: Aetna Medicare Advantage	$15.16
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12.89
Rate for Payer: Cigna Commercial	$25.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.14
Rate for Payer: Oxford Commercial	$10.11
Rate for Payer: Qualcare PPO/HMO/WC	$7.58
Rate for Payer: UnitedHealthcare Commercial	$10.11
Rate for Payer: UnitedHealthcare Community & State	$1.60
Rate for Payer: Wellpoint Medicaid Managed Care	$1.44

DRESSING AQUACEL AG 1/2x18IN

Facility

$57.73

Hospital Charge Code	270649155
Hospital Revenue Code	272
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$8.66
Rate for Payer: Qualcare PPO/HMO/WC	$8.66

DRESSING AQUACEL AG 1/2x18IN

Facility

$57.73

Hospital Charge Code	270649155
Hospital Revenue Code	272
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$28.86
Rate for Payer: Aetna Commercial	$21.94
Rate for Payer: Aetna Medicare Advantage	$17.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.72
Rate for Payer: Cigna Commercial	$28.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.01
Rate for Payer: Oxford Commercial	$11.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.66
Rate for Payer: UnitedHealthcare Commercial	$11.55
Rate for Payer: UnitedHealthcare Community & State	$1.82
Rate for Payer: Wellpoint Medicaid Managed Care	$1.64

DRESSING AQUACEL AG 3/4x18

Facility

$57.73

Hospital Charge Code	270638207
Hospital Revenue Code	272
Min. Negotiated Rate	$1.64
Max. Negotiated Rate	$28.86
Rate for Payer: Aetna Commercial	$21.94
Rate for Payer: Aetna Medicare Advantage	$17.32
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.72
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.72
Rate for Payer: Cigna Commercial	$28.86
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$15.01
Rate for Payer: Oxford Commercial	$11.55
Rate for Payer: Qualcare PPO/HMO/WC	$8.66
Rate for Payer: UnitedHealthcare Commercial	$11.55
Rate for Payer: UnitedHealthcare Community & State	$1.82
Rate for Payer: Wellpoint Medicaid Managed Care	$1.64

DRESSING AQUACEL AG 3/4x18

Facility

$57.73

Hospital Charge Code	270638207
Hospital Revenue Code	272
Min. Negotiated Rate	$8.66
Max. Negotiated Rate	$8.66
Rate for Payer: Qualcare PPO/HMO/WC	$8.66

DRESSING AQUACEL AG 3.5x12IN

Facility

$171.99

Hospital Charge Code	270654311
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

DRESSING AQUACEL AG 3.5x12IN

Facility

$171.99

Hospital Charge Code	270654311
Hospital Revenue Code	272
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$86.00
Rate for Payer: Aetna Commercial	$65.36
Rate for Payer: Aetna Medicare Advantage	$51.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$43.86
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$43.86
Rate for Payer: Cigna Commercial	$86.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$44.72
Rate for Payer: Oxford Commercial	$34.40
Rate for Payer: Qualcare PPO/HMO/WC	$25.80
Rate for Payer: UnitedHealthcare Commercial	$34.40
Rate for Payer: UnitedHealthcare Community & State	$5.43
Rate for Payer: Wellpoint Medicaid Managed Care	$4.88

DRESSING AQUACEL AG 3.5x13.75

Facility

$171.99

Hospital Charge Code	270677592
Hospital Revenue Code	272
Min. Negotiated Rate	$25.80
Max. Negotiated Rate	$25.80
Rate for Payer: Qualcare PPO/HMO/WC	$25.80

Know your out-of-pocket cost for care.

All Charges