Hoboken University Hospital

All Charges

Charge

Type

Setting

Price

EXCISOR FISCHER LARGE SHALLOW

Facility

$117.03

Hospital Charge Code	270608106
Hospital Revenue Code	272
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

EXCISOR FISCHER LARGE SHALLOW

Facility

$117.03

Hospital Charge Code	270608106
Hospital Revenue Code	272
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$58.52
Rate for Payer: Aetna Commercial	$44.47
Rate for Payer: Aetna Medicare Advantage	$35.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.43
Rate for Payer: Oxford Commercial	$23.41
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Commercial	$23.41
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$3.32

EXCISOR FISCHER MEDIUM

Facility

$117.03

Hospital Charge Code	270608105
Hospital Revenue Code	272
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$58.52
Rate for Payer: Aetna Commercial	$44.47
Rate for Payer: Aetna Medicare Advantage	$35.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.43
Rate for Payer: Oxford Commercial	$23.41
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Commercial	$23.41
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$3.32

EXCISOR FISCHER MEDIUM

Facility

$117.03

Hospital Charge Code	270608105
Hospital Revenue Code	272
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

EXCISOR FISCHER SMALL

Facility

$117.03

Hospital Charge Code	270608104
Hospital Revenue Code	272
Min. Negotiated Rate	$17.55
Max. Negotiated Rate	$17.55
Rate for Payer: Qualcare PPO/HMO/WC	$17.55

EXCISOR FISCHER SMALL

Facility

$117.03

Hospital Charge Code	270608104
Hospital Revenue Code	272
Min. Negotiated Rate	$3.32
Max. Negotiated Rate	$58.52
Rate for Payer: Aetna Commercial	$44.47
Rate for Payer: Aetna Medicare Advantage	$35.11
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$29.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$29.84
Rate for Payer: Cigna Commercial	$58.52
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$30.43
Rate for Payer: Oxford Commercial	$23.41
Rate for Payer: Qualcare PPO/HMO/WC	$17.55
Rate for Payer: UnitedHealthcare Commercial	$23.41
Rate for Payer: UnitedHealthcare Community & State	$3.70
Rate for Payer: Wellpoint Medicaid Managed Care	$3.32

EXC LEG/ANKLE LES SC 3 CM/> 50

Facility

$20,625.50

Service Code	HCPCS 27632
Hospital Charge Code	16000354
Hospital Revenue Code	360
Min. Negotiated Rate	$585.76
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,362.63
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$651.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$585.76

EXC LEG/ANKLE LES SC 3 CM/> 50

Facility

$20,625.50

Service Code	HCPCS 27632
Hospital Charge Code	16000354
Hospital Revenue Code	360
Min. Negotiated Rate	$3,093.82
Max. Negotiated Rate	$3,093.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82

EXC LEG/ANKLE TUM < 3 CM

Facility

$13,615.50

Service Code	HCPCS 27618
Hospital Charge Code	16000426
Hospital Revenue Code	360
Min. Negotiated Rate	$2,042.33
Max. Negotiated Rate	$2,042.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33

EXC LEG/ANKLE TUM < 3 CM

Facility

$13,615.50

Service Code	HCPCS 27618
Hospital Charge Code	16000426
Hospital Revenue Code	360
Min. Negotiated Rate	$386.68
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,540.03
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$430.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$386.68

EXC LEG/ANKLE TUM DEEP<5 CM RT

Facility

$13,615.50

Service Code	HCPCS 27619
Hospital Charge Code	16000624
Hospital Revenue Code	360
Min. Negotiated Rate	$386.68
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,540.03
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$430.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$386.68

EXC LEG/ANKLE TUM DEEP<5 CM RT

Facility

$13,615.50

Service Code	HCPCS 27619
Hospital Charge Code	16000624
Hospital Revenue Code	360
Min. Negotiated Rate	$2,042.33
Max. Negotiated Rate	$2,042.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33

EXC LEG/ANKLE TUM DEP 5 CM/>

Facility

$10,870.60

Service Code	HCPCS 27634
Hospital Charge Code	16000711
Hospital Revenue Code	360
Min. Negotiated Rate	$1,630.59
Max. Negotiated Rate	$1,630.59
Rate for Payer: Qualcare PPO/HMO/WC	$1,630.59

EXC LEG/ANKLE TUM DEP 5 CM/>

Facility

$10,870.60

Service Code	HCPCS 27634
Hospital Charge Code	16000711
Hospital Revenue Code	360
Min. Negotiated Rate	$308.73
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2,826.36
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$1,630.59
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$343.51
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$308.73

EXC LESION MENISCUS/CAPSULE

Facility

$19,467.90

Service Code	HCPCS 27347
Hospital Charge Code	16000881
Hospital Revenue Code	360
Min. Negotiated Rate	$552.89
Max. Negotiated Rate	$14,100.89
Rate for Payer: Aetna Commercial	$10,573.24
Rate for Payer: Aetna Medicare Advantage	$12,594.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$14,100.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,887.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$14,100.89
Rate for Payer: Cigna Commercial	$7,791.93
Rate for Payer: Cigna Medicare Advantage	$3,887.22
Rate for Payer: Clover Medicare Advantage	$3,692.86
Rate for Payer: EmblemHealth Commercial	$11,661.66
Rate for Payer: Humana Medicare Advantage	$4,003.84
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,887.22
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,061.65
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$615.19
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,887.22
Rate for Payer: Wellcare Medicare Advantage	$3,887.22
Rate for Payer: Wellpoint Medicaid Managed Care	$552.89

EXC LESION MENISCUS/CAPSULE

Facility

$19,467.90

Service Code	HCPCS 27347
Hospital Charge Code	16000881
Hospital Revenue Code	360
Min. Negotiated Rate	$2,920.18
Max. Negotiated Rate	$2,920.18
Rate for Payer: Qualcare PPO/HMO/WC	$2,920.18

EXC NECK LES SC < 3 CM

Facility

$13,615.50

Service Code	HCPCS 21555
Hospital Charge Code	16000323
Hospital Revenue Code	360
Min. Negotiated Rate	$2,042.33
Max. Negotiated Rate	$2,042.33
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33

EXC NECK LES SC < 3 CM

Facility

$13,615.50

Service Code	HCPCS 21555
Hospital Charge Code	16000323
Hospital Revenue Code	360
Min. Negotiated Rate	$386.68
Max. Negotiated Rate	$7,117.66
Rate for Payer: Aetna Commercial	$5,337.02
Rate for Payer: Aetna Medicare Advantage	$6,357.33
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$7,117.66
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$1,962.14
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$7,117.66
Rate for Payer: Cigna Commercial	$3,933.12
Rate for Payer: Cigna Medicare Advantage	$1,962.14
Rate for Payer: Clover Medicare Advantage	$1,864.03
Rate for Payer: EmblemHealth Commercial	$5,886.42
Rate for Payer: Humana Medicare Advantage	$2,021.00
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$1,962.14
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$3,540.03
Rate for Payer: Oxford Commercial	$5,018.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,042.33
Rate for Payer: UnitedHealthcare Commercial	$5,347.00
Rate for Payer: UnitedHealthcare Community & State	$430.25
Rate for Payer: UnitedHealthcare Medicare Advantage	$1,962.14
Rate for Payer: Wellcare Medicare Advantage	$1,962.14
Rate for Payer: Wellpoint Medicaid Managed Care	$386.68

EXC NECK LES SC 3+ CM

Facility

$22,285.25

Service Code	HCPCS 21552
Hospital Charge Code	16000209
Hospital Revenue Code	360
Min. Negotiated Rate	$632.90
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,794.16
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,342.79
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$704.21
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$632.90

EXC NECK LES SC 3+ CM

Facility

$22,285.25

Service Code	HCPCS 21552
Hospital Charge Code	16000209
Hospital Revenue Code	360
Min. Negotiated Rate	$3,342.79
Max. Negotiated Rate	$3,342.79
Rate for Payer: Qualcare PPO/HMO/WC	$3,342.79

EXC NECK TUM DEEP < 5 CM

Facility

$22,279.93

Service Code	HCPCS 21556
Hospital Charge Code	16000389
Hospital Revenue Code	360
Min. Negotiated Rate	$632.75
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,792.78
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,341.99
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$704.05
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$632.75

EXC NECK TUM DEEP < 5 CM

Facility

$22,279.93

Service Code	HCPCS 21556
Hospital Charge Code	16000389
Hospital Revenue Code	360
Min. Negotiated Rate	$3,341.99
Max. Negotiated Rate	$3,341.99
Rate for Payer: Qualcare PPO/HMO/WC	$3,341.99

EXC NECK TUM DEEP 5 CM/>

Facility

$20,625.50

Service Code	HCPCS 21554
Hospital Charge Code	16000373
Hospital Revenue Code	360
Min. Negotiated Rate	$3,093.82
Max. Negotiated Rate	$3,093.82
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82

EXC NECK TUM DEEP 5 CM/>

Facility

$20,625.50

Service Code	HCPCS 21554
Hospital Charge Code	16000373
Hospital Revenue Code	360
Min. Negotiated Rate	$585.76
Max. Negotiated Rate	$12,518.07
Rate for Payer: Aetna Commercial	$9,386.39
Rate for Payer: Aetna Medicare Advantage	$11,180.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$12,518.07
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$3,450.88
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$12,518.07
Rate for Payer: Cigna Commercial	$6,917.28
Rate for Payer: Cigna Medicare Advantage	$3,450.88
Rate for Payer: Clover Medicare Advantage	$3,278.34
Rate for Payer: EmblemHealth Commercial	$10,352.64
Rate for Payer: Humana Medicare Advantage	$3,554.41
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$3,450.88
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$5,362.63
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$3,093.82
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$651.77
Rate for Payer: UnitedHealthcare Medicare Advantage	$3,450.88
Rate for Payer: Wellcare Medicare Advantage	$3,450.88
Rate for Payer: Wellpoint Medicaid Managed Care	$585.76

EXC NEUROMA; CUTANEOUS NRV SUR

Facility

$16,424.70

Service Code	HCPCS 64774
Hospital Charge Code	160000194
Hospital Revenue Code	360
Min. Negotiated Rate	$466.46
Max. Negotiated Rate	$8,415.40
Rate for Payer: Aetna Commercial	$6,310.10
Rate for Payer: Aetna Medicare Advantage	$7,516.44
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$8,415.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$8,415.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Medicare Advantage	$2,319.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$3,536.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$8,415.40
Rate for Payer: Cigna Commercial	$4,650.22
Rate for Payer: Cigna Medicare Advantage	$2,319.89
Rate for Payer: Clover Medicare Advantage	$2,203.90
Rate for Payer: EmblemHealth Commercial	$6,959.67
Rate for Payer: Humana Medicare Advantage	$2,389.49
Rate for Payer: Longevity Health Plan of New Jersey Medicare Advantage	$2,319.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$4,270.42
Rate for Payer: Oxford Commercial	$7,525.00
Rate for Payer: Qualcare PPO/HMO/WC	$2,463.70
Rate for Payer: UnitedHealthcare Commercial	$8,192.00
Rate for Payer: UnitedHealthcare Community & State	$519.02
Rate for Payer: UnitedHealthcare Medicare Advantage	$2,319.89
Rate for Payer: Wellcare Medicare Advantage	$2,319.89
Rate for Payer: Wellpoint Medicaid Managed Care	$466.46

Know your out-of-pocket cost for care.

All Charges