Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

DRESSING SACRUM 18X18CM

Facility

$32.53

Hospital Charge Code	270685350
Hospital Revenue Code	272
Min. Negotiated Rate	$4.88
Max. Negotiated Rate	$4.88
Rate for Payer: Qualcare PPO/HMO/WC	$4.88

DRESSING SACRUM 18X18CM

Facility

$32.53

Hospital Charge Code	270685350
Hospital Revenue Code	272
Min. Negotiated Rate	$0.92
Max. Negotiated Rate	$16.27
Rate for Payer: Aetna Commercial	$12.36
Rate for Payer: Aetna Medicare Advantage	$9.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8.30
Rate for Payer: Cigna Commercial	$16.27
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$8.46
Rate for Payer: Oxford Commercial	$6.51
Rate for Payer: Qualcare PPO/HMO/WC	$4.88
Rate for Payer: UnitedHealthcare Commercial	$6.51
Rate for Payer: UnitedHealthcare Community & State	$1.03
Rate for Payer: Wellpoint Medicaid Managed Care	$0.92

DRESSING SACRUM 22X25CM

Facility

$51.34

Hospital Charge Code	270685379
Hospital Revenue Code	272
Min. Negotiated Rate	$7.70
Max. Negotiated Rate	$7.70
Rate for Payer: Qualcare PPO/HMO/WC	$7.70

DRESSING SACRUM 22X25CM

Facility

$51.34

Hospital Charge Code	270685379
Hospital Revenue Code	272
Min. Negotiated Rate	$1.46
Max. Negotiated Rate	$25.67
Rate for Payer: Aetna Commercial	$19.51
Rate for Payer: Aetna Medicare Advantage	$15.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.09
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.09
Rate for Payer: Cigna Commercial	$25.67
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.35
Rate for Payer: Oxford Commercial	$10.27
Rate for Payer: Qualcare PPO/HMO/WC	$7.70
Rate for Payer: UnitedHealthcare Commercial	$10.27
Rate for Payer: UnitedHealthcare Community & State	$1.62
Rate for Payer: Wellpoint Medicaid Managed Care	$1.46

DRESSING SENSATRAC WHTFOAM LG

Facility

$282.16

Hospital Charge Code	270655357
Hospital Revenue Code	271
Min. Negotiated Rate	$42.32
Max. Negotiated Rate	$42.32
Rate for Payer: Qualcare PPO/HMO/WC	$42.32

DRESSING SENSATRAC WHTFOAM LG

Facility

$282.16

Hospital Charge Code	270655357
Hospital Revenue Code	271
Min. Negotiated Rate	$8.01
Max. Negotiated Rate	$141.08
Rate for Payer: Aetna Commercial	$107.22
Rate for Payer: Aetna Medicare Advantage	$84.65
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$71.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$71.95
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$71.95
Rate for Payer: Cigna Commercial	$141.08
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$73.36
Rate for Payer: Oxford Commercial	$56.43
Rate for Payer: Qualcare PPO/HMO/WC	$42.32
Rate for Payer: UnitedHealthcare Commercial	$56.43
Rate for Payer: UnitedHealthcare Community & State	$8.92
Rate for Payer: Wellpoint Medicaid Managed Care	$8.01

DRESSING SILVERCEL 2 2 800202

Facility

$52.29

Hospital Charge Code	270646638
Hospital Revenue Code	272
Min. Negotiated Rate	$7.84
Max. Negotiated Rate	$7.84
Rate for Payer: Qualcare PPO/HMO/WC	$7.84

DRESSING SILVERCEL 2 2 800202

Facility

$52.29

Hospital Charge Code	270646638
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$26.14
Rate for Payer: Aetna Commercial	$19.87
Rate for Payer: Aetna Medicare Advantage	$15.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.33
Rate for Payer: Cigna Commercial	$26.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.60
Rate for Payer: Oxford Commercial	$10.46
Rate for Payer: Qualcare PPO/HMO/WC	$7.84
Rate for Payer: UnitedHealthcare Commercial	$10.46
Rate for Payer: UnitedHealthcare Community & State	$1.65
Rate for Payer: Wellpoint Medicaid Managed Care	$1.49

DRESSING SILVERCEL 2x2 800202

Facility

$52.29

Hospital Charge Code	270646638W
Hospital Revenue Code	272
Min. Negotiated Rate	$7.84
Max. Negotiated Rate	$7.84
Rate for Payer: Qualcare PPO/HMO/WC	$7.84

DRESSING SILVERCEL 2x2 800202

Facility

$52.29

Hospital Charge Code	270646638W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.49
Max. Negotiated Rate	$26.14
Rate for Payer: Aetna Commercial	$19.87
Rate for Payer: Aetna Medicare Advantage	$15.69
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$13.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$13.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$13.33
Rate for Payer: Cigna Commercial	$26.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$13.60
Rate for Payer: Oxford Commercial	$10.46
Rate for Payer: Qualcare PPO/HMO/WC	$7.84
Rate for Payer: UnitedHealthcare Commercial	$10.46
Rate for Payer: UnitedHealthcare Community & State	$1.65
Rate for Payer: Wellpoint Medicaid Managed Care	$1.49

DRESSING SILVERCELL 4.25x4.25

Facility

$40.00

Hospital Charge Code	270646630W
Hospital Revenue Code	272
Min. Negotiated Rate	$6.00
Max. Negotiated Rate	$6.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00

DRESSING SILVERCELL 4.25x4.25

Facility

$40.00

Hospital Charge Code	270646630W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.14
Max. Negotiated Rate	$20.00
Rate for Payer: Aetna Commercial	$15.20
Rate for Payer: Aetna Medicare Advantage	$12.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.20
Rate for Payer: Cigna Commercial	$20.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.40
Rate for Payer: Oxford Commercial	$8.00
Rate for Payer: Qualcare PPO/HMO/WC	$6.00
Rate for Payer: UnitedHealthcare Commercial	$8.00
Rate for Payer: UnitedHealthcare Community & State	$1.26
Rate for Payer: Wellpoint Medicaid Managed Care	$1.14

DRESSING SILVERCEL NON-AD 2x2

Facility

$16.18

Hospital Charge Code	270646631W
Hospital Revenue Code	272
Min. Negotiated Rate	$2.43
Max. Negotiated Rate	$2.43
Rate for Payer: Qualcare PPO/HMO/WC	$2.43

DRESSING SILVERCEL NON-AD 2x2

Facility

$16.18

Hospital Charge Code	270646631W
Hospital Revenue Code	272
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$8.09
Rate for Payer: Aetna Commercial	$6.15
Rate for Payer: Aetna Medicare Advantage	$4.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$4.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$4.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$4.13
Rate for Payer: Cigna Commercial	$8.09
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4.21
Rate for Payer: Oxford Commercial	$3.24
Rate for Payer: Qualcare PPO/HMO/WC	$2.43
Rate for Payer: UnitedHealthcare Commercial	$3.24
Rate for Payer: UnitedHealthcare Community & State	$0.51
Rate for Payer: Wellpoint Medicaid Managed Care	$0.46

DRESSING SILVERCEL NON-AD 4x4

Facility

$36.91

Hospital Charge Code	270646632W
Hospital Revenue Code	272
Min. Negotiated Rate	$5.54
Max. Negotiated Rate	$5.54
Rate for Payer: Qualcare PPO/HMO/WC	$5.54

DRESSING SILVERCEL NON-AD 4x4

Facility

$36.91

Hospital Charge Code	270646632W
Hospital Revenue Code	272
Min. Negotiated Rate	$1.05
Max. Negotiated Rate	$18.45
Rate for Payer: Aetna Commercial	$14.03
Rate for Payer: Aetna Medicare Advantage	$11.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$9.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$9.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$9.41
Rate for Payer: Cigna Commercial	$18.45
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$9.60
Rate for Payer: Oxford Commercial	$7.38
Rate for Payer: Qualcare PPO/HMO/WC	$5.54
Rate for Payer: UnitedHealthcare Commercial	$7.38
Rate for Payer: UnitedHealthcare Community & State	$1.17
Rate for Payer: Wellpoint Medicaid Managed Care	$1.05

DRESSING SILVERLON 4X5IN

Facility

$75.00

Hospital Charge Code	270690185
Hospital Revenue Code	272
Min. Negotiated Rate	$11.25
Max. Negotiated Rate	$11.25
Rate for Payer: Qualcare PPO/HMO/WC	$11.25

DRESSING SILVERLON 4X5IN

Facility

$75.00

Hospital Charge Code	270690185
Hospital Revenue Code	272
Min. Negotiated Rate	$2.13
Max. Negotiated Rate	$37.50
Rate for Payer: Aetna Commercial	$28.50
Rate for Payer: Aetna Medicare Advantage	$22.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$19.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$19.12
Rate for Payer: Cigna Commercial	$37.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$19.50
Rate for Payer: Oxford Commercial	$15.00
Rate for Payer: Qualcare PPO/HMO/WC	$11.25
Rate for Payer: UnitedHealthcare Commercial	$15.00
Rate for Payer: UnitedHealthcare Community & State	$2.37
Rate for Payer: Wellpoint Medicaid Managed Care	$2.13

DRESSING SORBION SACHET 4x4

Facility

$27.96

Hospital Charge Code	270678124
Hospital Revenue Code	272
Min. Negotiated Rate	$4.19
Max. Negotiated Rate	$4.19
Rate for Payer: Qualcare PPO/HMO/WC	$4.19

DRESSING SORBION SACHET 4x4

Facility

$27.96

Hospital Charge Code	270678124
Hospital Revenue Code	272
Min. Negotiated Rate	$0.79
Max. Negotiated Rate	$13.98
Rate for Payer: Aetna Commercial	$10.62
Rate for Payer: Aetna Medicare Advantage	$8.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7.13
Rate for Payer: Cigna Commercial	$13.98
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$7.27
Rate for Payer: Oxford Commercial	$5.59
Rate for Payer: Qualcare PPO/HMO/WC	$4.19
Rate for Payer: UnitedHealthcare Commercial	$5.59
Rate for Payer: UnitedHealthcare Community & State	$0.88
Rate for Payer: Wellpoint Medicaid Managed Care	$0.79

DRESSING SORBION SACHET 5x4

Facility

$41.98

Hospital Charge Code	270678125
Hospital Revenue Code	272
Min. Negotiated Rate	$6.30
Max. Negotiated Rate	$6.30
Rate for Payer: Qualcare PPO/HMO/WC	$6.30

DRESSING SORBION SACHET 5x4

Facility

$41.98

Hospital Charge Code	270678125
Hospital Revenue Code	272
Min. Negotiated Rate	$1.19
Max. Negotiated Rate	$20.99
Rate for Payer: Aetna Commercial	$15.95
Rate for Payer: Aetna Medicare Advantage	$12.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$10.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$10.70
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$10.70
Rate for Payer: Cigna Commercial	$20.99
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$10.91
Rate for Payer: Oxford Commercial	$8.40
Rate for Payer: Qualcare PPO/HMO/WC	$6.30
Rate for Payer: UnitedHealthcare Commercial	$8.40
Rate for Payer: UnitedHealthcare Community & State	$1.33
Rate for Payer: Wellpoint Medicaid Managed Care	$1.19

DRESSING SORBION SACHET 8x4

Facility

$56.45

Hospital Charge Code	270678126
Hospital Revenue Code	272
Min. Negotiated Rate	$1.60
Max. Negotiated Rate	$28.23
Rate for Payer: Aetna Commercial	$21.45
Rate for Payer: Aetna Medicare Advantage	$16.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14.39
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14.39
Rate for Payer: Cigna Commercial	$28.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$14.68
Rate for Payer: Oxford Commercial	$11.29
Rate for Payer: Qualcare PPO/HMO/WC	$8.47
Rate for Payer: UnitedHealthcare Commercial	$11.29
Rate for Payer: UnitedHealthcare Community & State	$1.78
Rate for Payer: Wellpoint Medicaid Managed Care	$1.60

DRESSING SORBION SACHET 8x4

Facility

$56.45

Hospital Charge Code	270678126
Hospital Revenue Code	272
Min. Negotiated Rate	$8.47
Max. Negotiated Rate	$8.47
Rate for Payer: Qualcare PPO/HMO/WC	$8.47

DRESSING SURESITE 2-3/8x2-3/4

Facility

$1.56

Hospital Charge Code	270350205
Hospital Revenue Code	272
Min. Negotiated Rate	$0.23
Max. Negotiated Rate	$0.23
Rate for Payer: Qualcare PPO/HMO/WC	$0.23

Know your out-of-pocket cost for care.

All Charges