Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DRESSING FOAM OVAL HEEL 3x3

Facility

$23.20

Hospital Charge Code	270641300
Hospital Revenue Code	272
Min. Negotiated Rate	$0.66
Max. Negotiated Rate	$11.60
Rate for Payer: Aetna Commercial	$8.82
Rate for Payer: Aetna Medicare Advantage	$6.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$5.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$5.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$5.92
Rate for Payer: Cigna Commercial	$11.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.03
Rate for Payer: Oxford Commercial	$4.64
Rate for Payer: Qualcare PPO/HMO/WC	$3.48
Rate for Payer: UnitedHealthcare Commercial	$4.64
Rate for Payer: UnitedHealthcare Community & State	$0.73
Rate for Payer: Wellpoint Medicaid Managed Care	$0.66

DRESSING GAUZE BOR 4x4 MSC3244

Facility

$2.00

Hospital Charge Code	270639868W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

DRESSING GAUZE BOR 4x4 MSC3244

Facility

$2.00

Hospital Charge Code	270639868W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$0.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$0.40
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

DRESSING GAUZE BOR 6x6 MSC3266

Facility

$11.73

Hospital Charge Code	270639869W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.33
Max. Negotiated Rate	$5.87
Rate for Payer: Aetna Commercial	$4.46
Rate for Payer: Aetna Medicare Advantage	$3.52
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.99
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.99
Rate for Payer: Cigna Commercial	$5.87
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.05
Rate for Payer: Oxford Commercial	$2.35
Rate for Payer: Qualcare PPO/HMO/WC	$1.76
Rate for Payer: UnitedHealthcare Commercial	$2.35
Rate for Payer: UnitedHealthcare Community & State	$0.37
Rate for Payer: Wellpoint Medicaid Managed Care	$0.33

DRESSING GAUZE BOR 6x6 MSC3266

Facility

$11.73

Hospital Charge Code	270639869W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.76
Max. Negotiated Rate	$1.76
Rate for Payer: Qualcare PPO/HMO/WC	$1.76

DRESSING GAUZE VASELINE 3X9

Facility

$1.99

Hospital Charge Code	270649993
Hospital Revenue Code	270
Min. Negotiated Rate	$0.30
Max. Negotiated Rate	$0.30
Rate for Payer: Qualcare PPO/HMO/WC	$0.30

DRESSING GAUZE VASELINE 3X9

Facility

$1.99

Hospital Charge Code	270649993
Hospital Revenue Code	270
Min. Negotiated Rate	$0.06
Max. Negotiated Rate	$1.00
Rate for Payer: Aetna Commercial	$0.76
Rate for Payer: Aetna Medicare Advantage	$0.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$0.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$0.51
Rate for Payer: Cigna Commercial	$1.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$0.52
Rate for Payer: Oxford Commercial	$0.40
Rate for Payer: Qualcare PPO/HMO/WC	$0.30
Rate for Payer: UnitedHealthcare Commercial	$0.40
Rate for Payer: UnitedHealthcare Community & State	$0.06
Rate for Payer: Wellpoint Medicaid Managed Care	$0.06

DRESSING GAUZE VASELINE 6X36

Facility

$5.05

Hospital Charge Code	270649716
Hospital Revenue Code	270
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$0.76
Rate for Payer: Qualcare PPO/HMO/WC	$0.76

DRESSING GAUZE VASELINE 6X36

Facility

$5.05

Hospital Charge Code	270649716
Hospital Revenue Code	270
Min. Negotiated Rate	$0.14
Max. Negotiated Rate	$2.52
Rate for Payer: Aetna Commercial	$1.92
Rate for Payer: Aetna Medicare Advantage	$1.51
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.29
Rate for Payer: Cigna Commercial	$2.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.31
Rate for Payer: Oxford Commercial	$1.01
Rate for Payer: Qualcare PPO/HMO/WC	$0.76
Rate for Payer: UnitedHealthcare Commercial	$1.01
Rate for Payer: UnitedHealthcare Community & State	$0.16
Rate for Payer: Wellpoint Medicaid Managed Care	$0.14

DRESSING GEL WOUND TRIAD 2.5OZ

Facility

$24.86

Hospital Charge Code	270689567
Hospital Revenue Code	272
Min. Negotiated Rate	$0.71
Max. Negotiated Rate	$12.43
Rate for Payer: Aetna Commercial	$9.45
Rate for Payer: Aetna Medicare Advantage	$7.46
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$6.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$6.34
Rate for Payer: Cigna Commercial	$12.43
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$6.46
Rate for Payer: Oxford Commercial	$4.97
Rate for Payer: Qualcare PPO/HMO/WC	$3.73
Rate for Payer: UnitedHealthcare Commercial	$4.97
Rate for Payer: UnitedHealthcare Community & State	$0.79
Rate for Payer: Wellpoint Medicaid Managed Care	$0.71

DRESSING GEL WOUND TRIAD 2.5OZ

Facility

$24.86

Hospital Charge Code	270689567
Hospital Revenue Code	272
Min. Negotiated Rate	$3.73
Max. Negotiated Rate	$3.73
Rate for Payer: Qualcare PPO/HMO/WC	$3.73

DRESSING GERM FLX 7 S 1X24 IN

Facility

$114.70

Hospital Charge Code	270684785
Hospital Revenue Code	272
Min. Negotiated Rate	$3.26
Max. Negotiated Rate	$57.35
Rate for Payer: Aetna Commercial	$43.59
Rate for Payer: Aetna Medicare Advantage	$34.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.25
Rate for Payer: Cigna Commercial	$57.35
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$29.82
Rate for Payer: Oxford Commercial	$22.94
Rate for Payer: Qualcare PPO/HMO/WC	$17.20
Rate for Payer: UnitedHealthcare Commercial	$22.94
Rate for Payer: UnitedHealthcare Community & State	$3.62
Rate for Payer: Wellpoint Medicaid Managed Care	$3.26

DRESSING GERM FLX 7 S 1X24 IN

Facility

$114.70

Hospital Charge Code	270684785
Hospital Revenue Code	272
Min. Negotiated Rate	$17.20
Max. Negotiated Rate	$17.20
Rate for Payer: Qualcare PPO/HMO/WC	$17.20

DRESSING HONEY CA ALGINATE 4X5

Facility

$43.07

Hospital Charge Code	270666018
Hospital Revenue Code	272
Min. Negotiated Rate	$1.22
Max. Negotiated Rate	$21.54
Rate for Payer: Aetna Commercial	$16.37
Rate for Payer: Aetna Medicare Advantage	$12.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.98
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.98
Rate for Payer: Cigna Commercial	$21.54
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$11.20
Rate for Payer: Oxford Commercial	$8.61
Rate for Payer: Qualcare PPO/HMO/WC	$6.46
Rate for Payer: UnitedHealthcare Commercial	$8.61
Rate for Payer: UnitedHealthcare Community & State	$1.36
Rate for Payer: Wellpoint Medicaid Managed Care	$1.22

DRESSING HONEY CA ALGINATE 4X5

Facility

$43.07

Hospital Charge Code	270666018
Hospital Revenue Code	272
Min. Negotiated Rate	$6.46
Max. Negotiated Rate	$6.46
Rate for Payer: Qualcare PPO/HMO/WC	$6.46

DRESSING HYDROCOLLOID 6X6

Facility

$12.74

Hospital Charge Code	270649914
Hospital Revenue Code	272
Min. Negotiated Rate	$1.91
Max. Negotiated Rate	$1.91
Rate for Payer: Qualcare PPO/HMO/WC	$1.91

DRESSING HYDROCOLLOID 6X6

Facility

$12.74

Hospital Charge Code	270649914
Hospital Revenue Code	272
Min. Negotiated Rate	$0.36
Max. Negotiated Rate	$6.37
Rate for Payer: Aetna Commercial	$4.84
Rate for Payer: Aetna Medicare Advantage	$3.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$3.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$3.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$3.25
Rate for Payer: Cigna Commercial	$6.37
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3.31
Rate for Payer: Oxford Commercial	$2.55
Rate for Payer: Qualcare PPO/HMO/WC	$1.91
Rate for Payer: UnitedHealthcare Commercial	$2.55
Rate for Payer: UnitedHealthcare Community & State	$0.40
Rate for Payer: Wellpoint Medicaid Managed Care	$0.36

DRESSING IV TRANSP 6x8

Facility

$6.22

Hospital Charge Code	270650240
Hospital Revenue Code	272
Min. Negotiated Rate	$0.18
Max. Negotiated Rate	$3.11
Rate for Payer: Aetna Commercial	$2.36
Rate for Payer: Aetna Medicare Advantage	$1.87
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1.59
Rate for Payer: Cigna Commercial	$3.11
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1.62
Rate for Payer: Oxford Commercial	$1.24
Rate for Payer: Qualcare PPO/HMO/WC	$0.93
Rate for Payer: UnitedHealthcare Commercial	$1.24
Rate for Payer: UnitedHealthcare Community & State	$0.20
Rate for Payer: Wellpoint Medicaid Managed Care	$0.18

DRESSING IV TRANSP 6x8

Facility

$6.22

Hospital Charge Code	270650240
Hospital Revenue Code	272
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$0.93
Rate for Payer: Qualcare PPO/HMO/WC	$0.93

DRESSING JOBST 4 LAYER 4927

Facility

$54.60

Hospital Charge Code	270659789
Hospital Revenue Code	272
Min. Negotiated Rate	$8.19
Max. Negotiated Rate	$8.19
Rate for Payer: Qualcare PPO/HMO/WC	$8.19

DRESSING JOBST 4 LAYER 4927

Facility

$54.60

Hospital Charge Code	270659789
Hospital Revenue Code	272
Min. Negotiated Rate	$1.55
Max. Negotiated Rate	$27.30
Rate for Payer: Aetna Commercial	$20.75
Rate for Payer: Aetna Medicare Advantage	$16.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.92
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.92
Rate for Payer: Cigna Commercial	$27.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.20
Rate for Payer: Oxford Commercial	$10.92
Rate for Payer: Qualcare PPO/HMO/WC	$8.19
Rate for Payer: UnitedHealthcare Commercial	$10.92
Rate for Payer: UnitedHealthcare Community & State	$1.73
Rate for Payer: Wellpoint Medicaid Managed Care	$1.55

DRESSING JUMP START

Facility

$95.00

Hospital Charge Code	270690016
Hospital Revenue Code	272
Min. Negotiated Rate	$2.70
Max. Negotiated Rate	$47.50
Rate for Payer: Aetna Commercial	$36.10
Rate for Payer: Aetna Medicare Advantage	$28.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$24.23
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$24.23
Rate for Payer: Cigna Commercial	$47.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$24.70
Rate for Payer: Oxford Commercial	$19.00
Rate for Payer: Qualcare PPO/HMO/WC	$14.25
Rate for Payer: UnitedHealthcare Commercial	$19.00
Rate for Payer: UnitedHealthcare Community & State	$3.00
Rate for Payer: Wellpoint Medicaid Managed Care	$2.70

DRESSING JUMP START

Facility

$95.00

Hospital Charge Code	270690016
Hospital Revenue Code	272
Min. Negotiated Rate	$14.25
Max. Negotiated Rate	$14.25
Rate for Payer: Qualcare PPO/HMO/WC	$14.25

DRESSING MAXORB EXT AG MSC9445

Facility

$39.40

Hospital Charge Code	270639867W
Hospital Revenue Code	272
Min. Negotiated Rate	$5.91
Max. Negotiated Rate	$5.91
Rate for Payer: Qualcare PPO/HMO/WC	$5.91

DRESSING MAXORB EXT AG MSC9445

Facility

$39.40

Hospital Charge Code	270639867W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.12
Max. Negotiated Rate	$19.70
Rate for Payer: Aetna Commercial	$14.97
Rate for Payer: Aetna Medicare Advantage	$11.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.05
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.05
Rate for Payer: Cigna Commercial	$19.70
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.24
Rate for Payer: Oxford Commercial	$7.88
Rate for Payer: Qualcare PPO/HMO/WC	$5.91
Rate for Payer: UnitedHealthcare Commercial	$7.88
Rate for Payer: UnitedHealthcare Community & State	$1.25
Rate for Payer: Wellpoint Medicaid Managed Care	$1.12

Know your out-of-pocket cost for care.

All Charges